Bankmed to you 3 Welcome letter from Dr Leighton McDonald 8 Tax credits for medical scheme contributions 12 Highway to health – know your benefits 17 Important contacts 47 The danger of over the-counter drugs
Lifestyle 4 9 24 54
World of Wellbeing summer 2011/12
Lifebytes Great gadgets Ace that interview Cyber security
14 Skin deep 48 Medicine cabinet must-haves
Healthy living 10 Q and A 34 Sugar-free holiday 44 On fertile ground 56 Absolute beginners 60 Foodbytes 62 Feeding picky eaters
66 68 70
Emotional wellbeing 18 Say ‘yes’ to ‘no’ 30 Together we can! 40 Beat the holiday blues 50 Relationship resolutions for 2012
Music and book reviews Downtime Kidszone
A weekend away with a difference
Bankmed Bounce your World of Wellbeing Summer 2011/12
What’s in your
EDITORIAL DIRECTOR Susan Newham editor Candice Verwey
Message from the CEO
ADVISORY BOARD Michelle Bam, Dr Buddy Modi, Felix Calitz, Angie Sime, Dr Leighton McDonald executive DIRECTORS Mark Beare, John Morkel HR MANAGER Jolinda Kemp ACCOUNTS Naeema Abrahams, Kauthar Cerff, Elmon Searle office manager Marché Jason Office aDMINIstration Tessa Mbanga ADVERTISING SALES Jean Ramsay: 079-508-0428 firstname.lastname@example.org
Published for Bankmed by The Publishing Partnership (Pty) Ltd, 9th Floor, 81 Loop Street, Cape Town 8001. Copyright The Publishing Partnership (Pty) Ltd 2011 Editorial enquiries: PO Box 15054, Vlaeberg 8018 Tel: 021-424-3517 Fax: 021-424-3612 Email: email@example.com Reproduction: Hirt & Carter Printing: Paarl Media Cape Disclaimer: The opinions expressed by the authors of the articles published in this magazine do not necessarily reflect the views of Bankmed or The Publishing Partnership (Pty) Ltd. Bankmed and The Publishing Partnership (Pty) Ltd do not accept any responsibility for information given in the articles featured in Bankmed magazine.
Cover Image Shutterstock
elcome to the summer edition of Bankmed’s Bounce magazine. This issue is packed with articles that are relevant for this time of the year and, as always, aim to empower you to make choices that will have a positive impact on your health and that of your family. With the holidays just around the corner, many of you are undoubtedly already dreaming of long, relaxing days spent with family around the braai or at the poolside. But with South Africa having one of the highest rates of skin cancer in the world, we urge you to take care in the sun. The article ‘Skin Deep’ on page 14 is loaded with useful tips for protecting your skin, as well as skin symptoms not to ignore. Given all the festive mayhem that is synonymous with this time of year, it is easy to forget that for many of us the holidays are not a happy time at all. In fact, the holiday season is one of the times when people are most susceptible to feelings of depression and loneliness. ‘Beat The Holiday Blues’ on page 40 addresses some of the issues that surround this time of the year, and offers guidance on how you can deal with them in a more positive and constructive way. ‘Sugar-Free Holiday’ on page 34 provides plenty of practical tips to help people with diabetes navigate the season of festive eating, while ‘Medicine Cabinet Must-Haves’ on page 48 offers advice on how to stock your medicine cabinet so that you will be ready for a variety of health issues that may arise during the holidays. The New Year is nearly here and we need to start preparing ourselves for a healthy year ahead. We strongly encourage you to view the Bankmed 2012 Benefit and Contribution Year
End DVD (also available for viewing on our website: www.bankmed. co.za), which is filled with Scheme information that will benefit you in the year ahead. And do take the time to read the 2012 Benefit and Contribution Schedule. Not only does it contain important Scheme information, but it will stand you in good stead for answering the competition question on page 39, in which you can win a luxurious weekend away at The Elephant Sanctuary in Hartbeespoortdam. Increase your chances of starting 2012 in good health by getting plenty of rest and travelling safely over the festive season. We will still be available to provide service to our members throughout the holiday season, so contact us on 0800 BANKMED (0800-226-5633) should this be necessary. Best wishes for a safe festive season and a happy and healthy year ahead. Dr Leighton McDonald Chief Executive Officer 03
Bankmed Bounce your World of Wellbeing Summer 2011/12
COPY EDITOR Anneke Sloman
2011/11/10 2:38 PM
ART DIRECTOR Tina Reddell
From socialising to scent therapy, here’s a roundup of tips to improve your wellbeing By candice verwey
Good news for social butterflies
Killer heels You might love your high heels, but do they love you? Research shows that high heels cause a build-up of pressure on the inside of the knee in direct proportion to the height of the heel, placing you at greater risk for joint disintegration and osteoarthritis in time. Heels also influence body posture, which can lead to lowerback strain. But if you’re a devotee of high heels, take these steps to minimise the risks: ■ Don’t wear your highest heels on days when you’ll be on your feet a lot. Save them for special occasions. ■ Alternate wearing heels with flats. As long as you’re in flats more than heels, your health should not suffer. ■ Taking stiletto strain? Stretch it out with this exercise: stand on a step and lower your heels over the edge one at a time, holding for 15 seconds on each side.
If you love to socialise then you'll know that a good chin wag over a cuppa coffee with friends is the ultimate mood booster. But did you know that it helps you live longer too? According to 148 studies reviewed by researchers at Brigham Young University in Utah, people with strong social connections improve their lifespan significantly. Apparently a low level of social interaction affects longevity to the same extent as alcoholism, and that's not all – the research indicates that it’s even worse for your health than obesity and a lifetime of not exercising. One of the reasons for the longevity link is that sociable people derive a sense of meaning and purpose from their relationships that translates into taking better care of themselves and taking fewer harmful risks. Relationships also act as a buffer against stress and are important for self-esteem. But not everyone is a natural – if you find socialising intimidating, you might find it easier with a new group of people than trying to reach out to old acquaintances. Consider joining a club of sorts, such as a hiking club, moms' group or support group, to meet new people and improve your social skills.
Desk stress Is the constant noise and lack of privacy at work getting to you? You’re not alone. Open-plan offices are linked with an increase in stress, increased blood pressure and a higher rate of staff turnover. If you’re not yet in a position to request a private office with a view, consider making your desk more private by putting up a divider of sorts. Alternatively, listen to your iPod or use ear plugs to drown out the background noise that serves to distract you and increase your stress levels.
Curry on! If you’re a fan of curries, you’ll be thrilled to hear that your gastronomic preference is pleasing to more than your taste buds. Capsaicin, the active component in chillies that delivers the heat, relaxes blood vessels, which, in time, can help towards lowering blood pressure. Curcumin, the active ingredient in the curry powder turmeric (or borrie, as it’s commonly called) may also help soothe joints and can even be taken as a supplement to help osteoarthritis sufferers. Just make sure your curry is tomato based rather than cream based, or else it won’t be as pleasing to your waistline.
Did you know? It is possible to be a junk-food junkie. Researchers are acknowledging that certain foods can become addictive, particularly those high in fat such as sausages and cheesecake. Apparently these foods cause changes in the brain’s reward system when eaten in excess, promoting addiction. So that's another good reason to limit the amount of fatty junk foods you consume.
Did you know that certain scents can improve your wellbeing and relieve a variety of health complaints? If you need a boost, try these: ■ Relieve a migraine with a green apple. The scent appears to decrease muscle contractions, which are largely responsible for these
headaches, says Dr Alan Hirsch, from The Smell and Taste Treatment and Research Foundation. He suggests bathing in green apple-scented bath salts, or eating a green apple (a more practical suggestion) as soon as you feel one of these debilitating headaches coming on. ■ Calm a crying baby with lavender. Ever wondered why so many baby products contain lavender? It’s thanks to lavender's incredibly calming properties. Try giving your baby a relaxing bath in lavender bath oil when they’re overstimulated and niggly at the end of a long day. ■ Reduce stress with the sweet smells of nature.
Being surrounded by nature is good for you, and researchers are saying there’s a very good reason for it – apparently freshly cut grass and green leaves release a number of chemicals that relieve stress when inhaled. If you can’t get to the park, try inhaling mango, lemon or lavender scents instead, which are also highly regarded for their stressrelieving properties. ■ Relieve anxiety with a humble orange. A study at the University of Vienna concluded that orange scent is the key to a more relaxed frame of mind. The study involved the use of orange essential oil to calm nerves and improve the moods of people awaiting dental treatment. 05
Bankmed Bounce your World of Wellbeing Summer 2011/12
giveaways Enjoy the soft touch of Glodina Glodina’s new Caribbean range of towels and bobble bath mats is so festive you’ll get into the holiday spirit just by looking at it. Taking their cue from palm trees, sandy beaches and brilliant blue ocean water, Glodina combined practicality with a dash of fun in the new range, while still providing all the comfort associated with the brand. The range is light, easy to machine-wash and quick to dry. Available at retailers countrywide and at Glodina factory shops. Visit the website at www.glodina.co.za for information on other Glodina ranges as well as tips on taking care of your towels. To be in line to win a hamper, We are giving away two hampers SMS the words Bounce/Glodina, of Glodina Caribbean towels. Each with your full name, postal address hamper is valued at R1 000 and contains two bath sheets, two bath and daytime phone number, to towels, two hand towels, two face 34509 by 31 January 2012. cloths and one bobble mat.
Water on tap Tap water may be safe, but it contains various substances that affect its taste and odour, such as chlorine, impurities and pesticides. Brita has a range of products that reduce these substances, and restore water's great taste. Look out for Brita at leading supermarkets and home stores, or online at yuppiechef.co.za and brita-water. co.za. We are giving away three Brita hydration packs. Each pack is valued at R850 and contains one water filter jug, one fill-and-go water filter bottle, a stainless steel bottle and a pack of two replacement filters. To be in line to win a hamper, SMS the words Bounce/Brita, with your full name, postal address and daytime phone number, to 34509 by 31 January 2012.
Good bugs for healthy skin You’ve probably heard that the probiotics in yoghurt are good for digestive health, but did you know that the topical use of probiotics is also beneficial? Babaderm, a new range of skin products for babies, contains the probiotic essence Probiton™, which has anti-inflammatory, antifungal and antibacterial properties to promote skin that is balanced and germ free. The range includes a soothing nappy cream (with olive and Emu oil), a germ-fighting body wash, a gentle shampoo and conditioner, a protecting body lotion and a caring probio oil. The Babaderm™ baby-care range is available at selected pharmacies and retail outlets countrywide and is suitable for all skin types. We are giving away five hampers of Babaderm products, valued at R422 each.
To be in line to win, SMS the words Bounce/Babaderm, with your full name, postal address and daytime phone number, to 34509 by 31 January 2012.
Metropolitan Health wishes all Bankmed members a blessed Festive Season, and a New Year filled with health, happiness and prosperity.
s Tax credits replace tax deduction for medical scheme contributions in the year ahead. Here’s what you need to know.
ccording to the Department of National Treasury, the new medical tax credit entails a reduction in tax liability/tax payable. The value of the tax credit will be equitable across income groups (that is, the tax credit will be calculated at the same rate for all taxpayers). Take note of the following from the Tax Laws Amendment Bill:
Medical scheme fees tax credit 6A. (1)A rebate, to be known as the medical scheme fees tax credit must be deducted from the normal tax payable by a taxpayer who is a natural person, unless the taxpayer is entitled to a rebate under section 6(2)(b). (2) (a) The medical scheme fees tax credit applies in respect of fees paid by the taxpayer to (i) a medical scheme registered under
the Medical Schemes Act, 1998 (Act No. 131 of 1998); or (ii) a fund which is registered under any similar provision contained in the laws of any other country where the medical scheme is registered. (b) The amount of the medical scheme fees tax credit must be (i) R216, in respect of benefits to the taxpayer; (ii) R432, in respect of benefits to the taxpayer and one dependant; or (iii) R432, in respect of benefits to the taxpayer and one dependant, plus R144 in respect of benefits to each additional dependant, for each month in that year of assessment in respect of which those fees are paid. (3) For the purposes of this section, any amount contemplated in subsection (2) that has been paid by (a) the estate of a deceased taxpayer
is deemed to have been paid by the taxpayer on the day before his or her death; or (b) an employer of the taxpayer is, to the extent that the amount has been included in the income of that taxpayer as a taxable benefit in terms of the Seventh Schedule, deemed to have been paid by that taxpayer. (4) For the purposes of this section a ‘dependant’ in relation to a taxpayer means a ‘dependant’ as defined in section 1 of the Medical Schemes Act, 1998 (Act No. 131 of 1998). (2) Subsection (1) comes into operation on 1 March 2012 and applies in respect of years of assessment commencing on or after that date. For further information, contact the South African Revenue Service (SARS) at 0800-007-277.
Tax credits for medical scheme contributions
Vitality’s new exercise range
Now you can exercise anywhere, anytime, with Discovery Vitality’s new exercise range. The exercise aids are designed to improve strength, build muscle and improve fitness levels. The range includes the following: ■ Skipping and speed ropes for an effective aerobic workout. ■ Hand grips. ■ Fitness balls for a whole-body workout that improves balance and strength. ■ Sit-up bars – these provide support when doing sit-up exercises. ■ Air-flow exercise mats for a cooler, dryer floor
workout when doing floor exercises. ■ Wrist and ankle weights for resistance training. ■ Pilates’ kits with twist boards, resistance tubing and super rings . ■ Stopwatches – and much more. Every product comes with clear instructions and a training guide. The exercise range is suitable for all fitness levels and can be used for a variety of fun routines that will keep you moving and get you fit! The range is available at VitalityMall on www.discovery.co.za for Vitality members, and at selected Dis-Chem stores.
We are giving away one hamper filled with exercise equipment from Vitality’s range. To be in line to win the hamper, sms the words Bounce/ Vitality with your full name, postal address and daytime phone number, as well as the answer to the following question: How many points does a single member need to get to Gold Vitality status? to 34509 by 31 January 2012.
By candice verwey
To stand a chance to win one, SMS the words Bounce/ Bissell, with your full name, postal address and daytime phone number, to 34509 by 31 January 2012.
Power clean with Bissell If you love your car, you’ll adore the Bissell Little Green™ Compact Multi-Purpose Deep Cleaner. Approved by the British Allergy Foundation, the Bissell range removes deepseated pet hair and detritus, dust mites, fibres and pollens from toys, mattresses, pillows, upholstery, carpets, rugs and curtains. It is also ideal for quickly cleaning up stains on carpets and upholstery, and the long power cord allows it to reach all the corners of a car. Retail price: R1 500. Available at leading retailers or from Tevo: 0861-77-88-88. For more information visit the website at www.bissell.co.za. We are giving away two Bissell Little Green Compact Multi-Purpose Deep-Cleaners, worth R1 500 each.
Clever kids The LeapPad Explorer is a durable educational tool designed for little hands and big imaginations. It is suitable for children aged four to nine years and includes a variety of applications and games that help develop basic computer literacy skills, enabling them to thrive both in school and, ultimately, in the workplace. Retail price: R1 199. Available at DionWired: www.dionwired.co.za. 09
Bankmed Bounce your World of Wellbeing Summer 2011/12
dies. Your update on the latest tech goo
From a love of fruit to teenage insecurity, Dr Modi answers your questions
With Dr Buddy Modi
Send your questions to firstname.lastname@example.org
My husband recently had a heart attack and has been displaying the symptoms of depression since the incident. Is this common?
Yes, it is. Research indicates that people with a chronic medical illness have a higher rate of depression by as much as 40 percent. Many people feel sad, nervous and ‘down’ after a heart attack, cardiac surgery, or a diagnosis of heart disease. These emotions may be triggered by fear, not knowing what to expect, not being able to do the things they used to do, fatigue and other issues. Encourage your husband to get up and get dressed every day, exercise, resume hobbies and social activities, eat healthily and rest when needed. If the feelings of sadness are temporary, they should abate within a few weeks. However, if your husband’s depressed mood continues, or he starts withdrawing from life, not caring when family and friends visit, becoming overly emotional, or increasingly negative, he needs to get help. Visit the South African Anxiety and Depression Group (SADAG) website: www.sadag.org, or call: 0800-20-50-26. If your husband is not ready to seek professional help, advise him to complete the Bankmed Personal Stress Assessment (PSA), available at www.bankmed.co.za, to determine his mental state.
I love fruit and always thought I was doing my body a favour by snacking on it throughout the day. Recently someone told me that too much can be bad for you. Is this true? I eat about eight servings every day.
Fruit is a great source of fibre, vitamins and antioxidants and is an essential part of a healthy diet. Itâ€™s great that you are in the habit of snacking on fruit rather than on less healthy foods, but the downside to consuming such a large quantity every day is that you may be missing out on several key nutrients that are less abundant in fruit, such as calcium. For example, if all your mid-meals and desserts consist of fruit, fitting in the recommended three daily servings of dairy may be difficult. This could compromise your calcium intake. If you reduce the amount of fruit you consume to the recommended two to three servings a day, youâ€™ll create space in your diet to enjoy other nutritious snacks,
such as yoghurt, wholegrain crackers, seeds and nuts, which would promote a more balanced diet. Something else to keep in mind is that an excess of sugar, including fruit sugar, in the diet causes blood sugar highs and lows, which have a negative impact on mood, energy levels and appetite. Research also indicates that the sugar in fruit has much the same effect on your teeth as the sugar in sweets. To avoid these issues, try eating some protein with each piece of fruit. A slice of cheese in particular is a good choice â€“ the protein will prevent blood sugar levels from spiking and the alkalinity of cheese will counter the acidity of the fruit, which is responsible for tooth demineralisation and decay.
Some people are more susceptible to focusing on their imperfections than others. Unfortunately, women tend to suffer more from this than men, especially those who compare themselves to idealised standards of beauty such as the images portrayed in popular magazines. Teenage girls are particularly vulnerable in this regard. It can be extremely concerning for a parent to hear their child speak this way, but the fact that she is comfortable telling you how she feels is a good sign. It shows that she trusts you enough to be honest with you. Encourage your daughter to stop comparing herself to others, especially to pictures of models whose airbrushed perfection is not real or realistic. Emphasise her good points and regularly reinforce that physical beauty is no reflection of her worth as
a person; that she has so much more to offer than just looks. Remind her to see herself as a total package, including personality traits like warmth, humour and intelligence, and to see others that way too. Encourage your daughter to try different hobbies and sports, so that
she can find an enjoyable and healthy outlet for her emotions, and make sure that you are always available to listen and offer guidance when she needs it. The teenage years can be tough and having a supportive parent by her side will make all the difference.
DO YOU HAVE A QUESTION? Send your questions to email@example.com. We regret that letters cannot be answered personally. For further information on your benefits, refer to your plans and benefits for 2012, available at www.bankmed.co.za.
Bankmed Bounce your World of Wellbeing Summer 2011/12
My teenage daughter tells me that when she looks in the mirror all she can see are her faults. I am concerned about her self-image. How can I help her to be more confident?
Highway to health e
Know your benefits for 2012 and tak control of your health.
y now you will have received your Benefit and Contribution Schedule for 2012 and may already have exercised a plan change. We would like to take this opportunity to remind you of the importance of knowing your benefits and encourage you to take the necessary steps towards promoting good health for you and your family in 2012. Note the following enhancements for the year ahead that will support you in your journey to good health: ■ Glaucoma screening – every beneficiary who is 55 years or older will be entitled to one glaucoma screening as an insured benefit, without reducing any other benefit 12
category or limit available to you in 2012, no matter which plan you are on. If you see an optician, try to tie in your glaucoma-screening test with one of your regular consultations. This will eliminate the need to schedule the test as a separate consultation process. ■ Childhood vaccinations – Bankmed will cover the cost of a range of vaccinations for babies up to the age of 18 months. Read more about this and other Bankmed Wellness and Preventative Care Benefits in your 2012 Benefit and Contribution Schedule. Remember, though, that the wellness and preventative care offering refers specifically to the cost of the
■ Additional post-hospital GP consultation – it is very important that you visit your GP after you have been in hospital to assess your posthospitalisation progress and state of health, and to make sure that you are not suffering from any underlying complications. To encourage you to take control of your health, Bankmed will cover the cost of an additional consultation (as an insured benefit, at the relevant Scheme rate for a GP consultation) for any beneficiary visiting a GP within 30 days of discharge, following an authorised hospital admission that resulted in an overnight stay. Basic and Core Saver members need to visit their selected CareCross GP (Basic) or nominated Bankmed Network GP (Core Saver) to access this benefit, as benefits on these plans are structured around the utilisation of network doctors as the primary co-ordinators of care. These are just a few of the benefit enhancements for 2012. You can read more about these and other improvements in the plan-specific Summary of Benefit and Contribution Changes we sent you in October. You can also take a closer look at the full range of benefits for 2012 in your Benefit and Contribution Schedule. We look forward to partnering with you in good health in the year ahead. Know your benefits, and take care. The Bankmed Team
listed vaccinations and screenings. Consultation fees remain payable from your day-to-day benefits. This is probably not a consideration if you have ample consultation benefits available for the year, for example if you and your dependants don't visit the doctor often, but if you wish to stretch your consultation benefits, you might prefer to combine vaccinations and screening appointments with your regular checkups or other GP visits.
Just what the Doctor ordered...
Dry Eye Caps
• Aimed at the root of the problem namely, to increase tear secretion, improve the quality of the tear distribution across the surface of the eye and optimize the stability of the aqueous tear film • Contains an approved proprietary herbal extract plus flax seed oil and lecithin. It is suitable for diabetics
Eyes Rx Plus
• Specialised formulation for use by those with degenerative eye disorders including age related macular degeneration, retinitis pigmentosa, glaucoma and cataracts • Provides relevant carotenoids, phytonutrients and an extremely potent anti-oxidant combination
• Specifically designed to help protect smokers from the damaging efects of free radicals caused by smoking • Provides potent anti-oxidants, combined with the relevant co-factors, to boost smokers’ immune systems and minimise lung tissue damage
• Amino acid which assists in healing damaged cells • For treatment of cold sores / fever blisters • Ideal for use when one has sun blisters
L-Lysine Lip Cream
• Assists in relieving cold sores, sun and fever blisters • Includes tea tree oil, lysine and zinc oxide • For effective relief use the tablets and lip cream in conjunction with each other
Available from selected pharmacies and health shops. www.fithealth.co.za firstname.lastname@example.org Tel: 011 886 2932 All Fithealth products are NAPPI coded.
vitamins minerals & herbs
skin deep Our long-awaited summer is here, but with South Africa having one of the highest skin cancer rates in the world, taking special care to protect ourselves in the sun is vital. By michelle pentecost
e’ve all made the mistake of spending too much time in the sun and suffered the uncomfortable consequences, but the risks of extended sun exposure go beyond sunburn. According to the Cancer Association of South Africa (CANSA), skin cancer is the most common form of cancer in South Africa and an estimated 20 000 cases are reported every year. ‘Skin cancer can be prevented,’ says Sue Janse van Rensburg, CANSA’s CEO. ‘You must make sure you and your loved ones play safe all year round but especially in summer, when the sun’s rays are the harshest. Children and the youth should take special precaution – two blistering burns before the age of 18 can dramatically increase your risk of getting cancer later in life.’ Protecting yourself and your family may not just eliminate the need for soothing after-sun products, but may well be a lifesaving measure.
The chief cause of skin cancer is overexposure to ultraviolet (UV) radiation from the sun or sunbeds. Two types of ultraviolet rays exist: UVA and UVB. UVB is responsible for the effects on the superficial layers of the skin, resulting in tanning or burning. The sought-after ‘healthylooking tan’ is really the result of the body’s response to skin damage. UVA rays reach the deeper layers of the skin, causing cell damage which contributes significantly to premature ageing. This means that if you’re committed to achieving a golden glow in your 20s, you’re likely to look far older than your years by the time you reach your 40s. But that’s not the worst of it. All UV rays damage skin cells, which can trigger their mutation into cancerous cells. Dr Dagmar Whitaker, president of the Melanoma Advisory Board of South Africa, explains: ‘If you grew up in this country and are fair skinned and did not protect your skin, the likelihood of some form of skin cancer at some stage in your life approaches 100 percent. The red and scaly spots on the face and arms and sores on the scalps of older people are seen so commonly in South Africa that we consider it normal, but it is not.’ Sunbeds are even worse than the sun. They produce their tanning effect through direct UVA radiation. Consequently, their use carries a significantly increased risk of skin cancer.
What are the common types of skin cancer? ‘Actinic or solar keratosis, Bowen’s disease, basal cell carcinomas, squamous cell carcinomas and, finally, the malignant melanoma are all different forms and types of skin cancer,’ says Dr Whitaker. Basal cell
carcinoma (commonly referred to as a rodent ulcer) is the most common malignant skin tumour and has the appearance of a translucent nodule, or a sore/lesion that won’t heal. It may also ooze or form a scab. It is slow growing, but can recur even after removal. Actinic keratoses are also common among South Africans. ‘These are in fact early forms of squamous cell carcinoma,’ explains Dr Whitaker. Actinic keratoses are red, scaly patches commonly seen on the sun-exposed skin of older people – these can ulcerate or form crusted plaques to become squamous cell carcinomas. Less common but far more aggressive is the
UVA rays reach the deeper layers of the skin causing cell damage, which contributes significantly to premature ageing malignant melanoma. ‘If not detected early, this cancer is fatal,’ says Dr Whitaker. Malignant melanoma develops in the pigment cells of the skin, and can spread to other parts of the body. Early signs of melanoma are changes to the shape or colour of existing moles, or the appearance of a new lump anywhere on the skin. Early detection and diagnosis are crucial, so it is vital to contact a healthcare professional if you notice any new skin growths or irregularities to existing moles.
Who is most at risk? ■ Fair skins. Blue eyes and blonde hair are not a good combination when it comes to skin cancer. Fair-skinned and fair-haired people with light-coloured eyes are especially at risk. Darkerskinned people have higher amounts of melanin in the skin, which protects
from sun damage. However, skin cancer can occur in any skin type. ■ History of skin cancer. ‘A family history of melanoma increases your risk of this condition,’ explains Dr Whitaker. If you have had a skin cancer removed, you are also more at risk of this condition recurring. ■ Excess sun exposure. It’s not difficult to meet this criterion in our sunny climate. Those who spend a lot of time outdoors in their occupations or hobbies are particularly at risk, especially if they’re not covering up adequately. We all remember to pack the sunscreen for a trip to the beach, but we should be applying sunscreen for all outdoor activities, including sports, driving, gardening, braaiing, washing the car, or admiring the view from a restaurant’s patio. It’s important to remember that you’re not protected by sitting in the shade and a cloudy day doesn’t mean that those UV rays aren’t reaching the earth. UV rays also reflect off water, sand, glass and other surfaces, so you may be exposed without feeling the sun beating down on your brow. ■ Childhood sunburns. According to CANSA, 80 percent of sun damage occurs during childhood and adolescence, with the effects only becoming apparent in adulthood. Babies should be completely shielded from sunlight and parents should ensure that children are wearing protective clothes 15
Bankmed Bounce your World of Wellbeing Summer 2011/12
What causes skin cancer?
must be followed up regularly, and anyone who experiences a mole itching, bleeding, growing or changing in appearance should see a dermatologist without delay.’ ■ Albinism. People with this condition are advised to follow stringent sun protection measures as they have an increased risk of skin cancer.
Safe skin practices Fortunately, there’s a lot that you can do to protect yourself and your loved ones from sun damage. Be vigilent in adhering to these rules: ■ Limit sun exposure. Easier said than done when we want to enjoy our glorious summer. If you are going to be outside, at least limit the time spent out of doors between 10am and 3pm, when the sun is at its most dangerous. ■ Cover up. Wear protective gear including sunglasses with adequate UV protection (400+) and a wide-brimmed hat. Make sure that your clothes are made of a tightly woven fabric to prevent UV rays from penetrating. ■ Cream it. Wear an SPF 20 or higher sunscreen every day on exposed areas, making sure to cover oft-forgotten areas such as the back of the neck, the
The ABCs of mole spotting Check yourself, your partner and your children regularly for moles that show signs of abnormality using the ABCD rule: Harmless moles A: Assymetry
Usually symmetrical and rounded with a regular shape
Smooth and well defined
Irregular edges, not well defined
Usually uniform black or brown
Multicoloured, including red, brown, black, blue and white
More than 6mm
Suspicious moles Assymetrical
Bankmed’s Special Care Oncology Programme offers assistance with pre-authorisation of oncology treatment, clinical advice and guidance, and basic counselling for members with cancer. To find out more about the programme, call: 0800-BANKMED (0800226-5633), or send an email to email@example.com.
ears and hands. Reapply the sunscreen two hourly, or more frequently if you are swimming or sweating. CANSA says: ‘Many people use less sunscreen than they should. Sunscreen manufacturers have an internationally agreed application thickness of 2mg per square centimetre of skin surface. This is about one-third of a bottle of sunscreen for the body of an adult in a swimming costume.’ And don’t forget to protect your lips – use lip balm with a minimum of SPF 20 and apply regularly. ■ Drive safely. Have your car fitted with tinted motor glass approved for filtering UV rays. ■ Medicine matters. Certain medications including retinoids, blood pressure medication, cholesterolreducing medication, antibiotics and pain medications such as ibuprofen can increase the skin’s sensitivity to UV radiation – be aware of this side effect and increase your sun protection. ■ Fake it. Never use a sunbed or sun lamp and avoid pills that promise a ‘tan from the inside’. These are unsafe and can be harmful to the skin and the liver. Rather opt for self-tanning products that can be applied at a salon or at home, but remember that you still need to apply sunscreen over your fake tan. For additional information, advice or support, contact CANSA by email: info@ cansa.org.za, phone: 0800-226-622, or visit their website: www.cansa.org.za.
and a sunscreen when outdoors. ■ Immuno-compromised individuals. Conditions that weaken the immune system also weaken the skin’s defences against developing cancers. Organ transplant patients and those with HIV/Aids or leukaemia need to take extra precautions. ■ Abnormal moles and precancerous skin lesions. People with multiple moles or sun spots may have an increased risk of these becoming cancerous, especially if the moles have an abnormal appearance. ‘Fair-skinned individuals should go for regular checkups after age 50,’ says Dr Whitaker, adding that any red, scaly spots that appear and sores that will not heal should be checked out. She advises anyone with moles to have at least one skin check to determine if they are worrisome or not. ‘Anyone who has more than 50 moles or five atypical moles
Who you gonna call?
information on Need emergency dental advice or lth bases covered heart health? This list has all the hea
ou never know when you’re going to need important health and safety contacts, but when you do, you’ll probably need them in a hurry. Don’t resort to leafing through the Yellow Pages; cut out and keep this list together with your list of Bankmed contacts (page 72) for easy access.
■ Allied Health Professions Council of South Africa Health body established to control all allied health professions, including Ayurveda, Chinese medicine and acupuncture, chiropractic treatment, homeopathy, naturopathy, osteopathy, phytotherapy, and therapeutic aromatherapy, massage and reflexology practices. T: 012-329-4001 F: 012-329-2279 www.ahpcsa.co.za
■ Dental Association of South Africa Promotes better dental health and ethical dental practices. T: 011-484-5288 F: 011-642-5718 firstname.lastname@example.org www.sada.co.za ■ Department of Health Delivers health services and important health information to the public. T: 012-395-8000 F: 012-395-9019 www.doh.gov.za
■ Health Professions Council of South Africa Protects the rights of patients and offers guidance to registered healthcare practitioners. T: 012-338-9301 F: 012-328-5120 email@example.com www.hpcsa.co.za ■ Human Sciences Research Council Conducts research relating to all aspects of human and social development in South Africa. T: 012-302-2000 F: 012-302-2001 www.hsrc.ac.za ■ Medicines Control Council Oversees the regulation of medicines in South Africa. T: 012-395-8000 www.mccza.com
■ The South African Heart Association Represents the professional interests of the country's cardiologists and cardio-thoracic surgeons. T: 021-931-8210 F: 021-931-8210 firstname.lastname@example.org www.saheart.org ■ The South African Nursing Council Established to regulate the nursing and midwifery professions, ensuring safe and quality practice. T: 012-420-1000 F: 012-343-5400 email@example.com www.sanc.co.za ■ The South African Pharmacy Council Protects the health, safety and wellbeing of patients and the public who use pharmaceutical services. T: 0861-727-200 F: 012-321-1492 firstname.lastname@example.org www.pharmcouncil.co.za
■ Road Accident Fund Provides cover for motor incidents and actively promotes the safe use of our roads. T: 012-429-5000 F: 012-429-5500 www.raf.co.za ■ South African Medical Research Council Conducts health research to improve the nation's health and quality of life. T: 021-938-0911 F: 021-938-0200 email@example.com www.mrc.ac.za 17
Bankmed Bounce your World of Wellbeing Summer 2011/12
say ‘yes’ to ‘no’ or babysitting Always lending money to a friend don’t want to? your sister’s kids, even though you how to put your There’s an art to saying ‘no’. Here’s catherine eden foot down and feel fine about it. By
‘yes’ to relatives who want to come and stay with us over the Christmas period. I’m not willing to turn our small house into a hotel and I want her to tell them it’s not convenient. She is in a panic about back-tracking and offending them.’
Are you a people pleaser? There are certain archetypal roles associated with doormat syndrome: the rescuer, victim, taker and bully all play a part in challenging the doormat’s people-pleasing ways. ‘People pleasers want others to like them, so they give in to all sorts of demands, just to remain in the other’s favour,’ explains Dr Aneta Shaw, a psychologist in private practice in Green Point and Somerset West in the Cape. ‘They are also conflict avoiders, fearing the displeasure of others more than the inevitable resentment that builds up inside them. Sometimes that resentment reaches a pitch where only an explosion can give relief. In that instant the doormat can turn into the
bully who has no regard for the other person’s feelings. ‘For every doormat there is also a taker, that person who will push and push and see how much they can get away with. If the taker is manipulative as well, they will play the doormat like a toy, knowing just how to win the doormat back when they finally threaten to end the unhealthy one-way relationship.’
arianne is one of those people who will always help a friend in a crisis. She has a family and a responsible job, but she will offer to do your shopping, collect you from the airport, or bake your child’s birthday cake because you are running late. She regularly bails out her brother who can’t manage money; she volunteers for the PTA and pours tea every Saturday morning at the school sports events. She agrees to every request at work, whether it is to take on a task that is not in her job description or to mentor new employees. Everyone likes Marianne because she is so kind and accommodating – but she is heading for a crash. Paul, Marianne’s husband, is getting fed up with her. ‘She’s permanently exhausted and lately she’s been feeling resentful about having too much to do. I tell her it’s her own fault, because she allows everyone to take advantage of her, but she can’t seem to stop. And now she is in a state because she didn’t ask me before she automatically said
Why does Marianne hear herself saying ‘Yes, of course I’ll help’ when what she really wants to say is ‘Sorry, but this time I can’t’? There are a number of reasons why we don’t honour that inner voice that knows what is best for us, says Shaw. If you are the oldest child in your family, it may have taken you longer to learn
In adulthood, the over-protected, disempowered girl will find it very difficult to express her own opinion OR make an unpopular choice to say ‘no’ since you probably grew up with your parents’ expectation that you would set an example to your siblings by being obedient and accommodating. As children we are taught not to make
a fuss; to do as we are told rather than wanting to have our own way. Girls, particularly, are encouraged to serve others, to hang back and not be selfish or assertive. In adulthood, the 19
Bankmed Bounce your World of Wellbeing
Why can’t we say ‘no’?
People pleasers need to develop a stronger sense of self, to trust and respect their own needs and not look for validation from the outside world over-protected, disempowered girl will find it very difficult to express her own opinion, make an unpopular choice or insist on being treated with respect and equality. She will be more inclined to let other people take charge and will meekly go along with their requests and decisions. People pleasers need to develop a stronger sense of self, to trust and respect their own needs and not constantly look for validation from the outside world. They have to learn that the sky won’t fall if they occasionally say ‘no’.
We don’t want to get to the point where we are so swamped by demands that we unleash the bully and snap at our friends. So what is the way out? The first step is to tune in to your inner voice, to become aware of what it is saying. Take a deep breath before you commit to give yourself a chance to sense if this is a request you would be happy to fulfill, or if it is one that you ought to decline. And if it is, give yourself permission to be honest. ‘Practise saying “no” in an easy situation that isn’t going to cause a train smash,’ says Shaw. So instead of agreeing to go to a movie that you don’t want to see, say, ‘Thanks for the invitation, but not this time. I’d love to come with you when there is something showing that I’d really like to see.’ Express assertiveness in small ways: ‘It’s your choice to smoke, but 20
Break the cycle
life force out of you. They are the ones who always involve you in their dramas. They will phone at 10pm needing your assistance, your spare bed or an urgent, rather large loan. Julia Cameron, author of The Artist’s Way (Pan), calls these people ‘crazymakers’. ‘They are often charismatic, frequently charming, highly inventive, and powerfully persuasive,’ she writes. They lurch from crisis to crisis and drag you along with them because they have convinced you that there is really no-one else they can turn to.
on you and ultimately deprive them of the opportunity to develop independence and responsibility. There’s always room for kindness and compassion, but when you overdo it you don’t really help the crazy-maker. Ask yourself if you keep helping out because you like being needed, or because this person’s problems are providing a useful distraction from your own. Once you understand why you are so willing and available to rescue, you’ll find it easier to put boundaries in place. And if the crazy-maker is in your immediate family, get some support from a professional. Substance abuse clinics have family programmes that help you to stop your enabling behaviour and develop a few sanitypreserving skills.
Set some goals
Beware of vampires
You don’t have to go into a long explanation about why you aren’t available, although it may make the ‘no’ a little sweeter
Sometimes, saying ‘yes’ to a situation is just an apathetic response to something we could change if we really wanted to. There are many areas of life where we tolerate circumstances that sap our energy: an unhealthy diet and lifestyle, unhappiness at work, or toxic relationships. You can probably think of one or two people who drain the
This may be unwelcome news, but you are getting something out of the relationship with your particular crazy-maker. If you are a rescuer who feels good about helping others, you will always find a ‘victim’ who needs your services. What you have to remember is that by constantly saving others, you make them dependent
Ask people pleasers what they really want and they will have a hard time answering, because they are so focused on what everyone else wants. People pleasers will never say ‘no’ with conviction if they aren’t clear about their own aspirations. So, if you are one of them, consider what your life would be like if you were less available for seeing to everyone else. What would you do with the extra time? Dare to plan a day in which you stick to your own programme. How you think has an impact on how you feel and what you do, so visualise yourself moving through the day, accomplishing your goals. When you can ‘see’ the way ahead, you will be less likely to be thrown off balance by other peoples’ agendas. The stronger your sense of direction, the greater your clarity about making choices that support your dreams. Of course you will still say ‘yes’ to friends and family, but you will at last be able to say ‘no’ when the person who needs the most help is you. 21
Bankmed Bounce your World of Wellbeing Summer 2011/12
I’d appreciate it if you didn’t light up in the house.’ ‘I know you want to chat, but it’s not a good time now. I’ll call you tomorrow.’ You don’t have to go into a long explanation about why you aren’t available, says Shaw, although it may make the ‘no’ a little sweeter. And you don’t always have to have a cast-iron excuse for why you aren’t willing to drop everything each time someone bleats for help. Say ‘no’ once and what will probably happen is that next time you’ll be asked if it’s a convenient time to talk, or if you could possibly find a free hour to help with a project. You will hear the respect for your time implicit in the question. ‘Assertiveness means that you take your own needs just as seriously as the needs of others,’ she says. ‘People pleasers need to realise that the world will carry on fine without their input and involvement. If they fear conflict, they should remind themselves that saying “no” is not a confrontation. It is merely a statement that they are not able to deliver in that particular instance. There’s no need to feel guilty about it. This is what is called a healthy boundary.’
Ace that interview I
nterviewing is an art, not a science. That’s both the good news and the bad news. While it’s true that there is no one formula that can be followed to guarantee your success, there are some tried and trusted tips that will help maximise your chances. Then it’s up to you to dazzle on the day.
Be on time
For an interview, this means at least 10 minutes early. Nothing will sour a first impression quicker than tardiness and you’re likely to arrive completely frazzled if you’re running late. Make sure you know exactly how to get to your destination and allow for a buffer of at least half an hour for traffic issues and other unforeseen complications.
Confidence is key – it says that you believe in yourself, which gives the impression that you’re able to take on a challenge. Of course, confidence is hard to project when you’re trembling like jelly inside. Deal with your nerves by taking deep, calming breaths before stepping into the interview. You should still be yourself, but a calm, secure version of yourself. Be sure to greet your interviewer with a firm handshake, secure eye contact and a friendly smile, and be aware of your body language – fidgeting is distracting and a dead give away that you’re nervous. Relax and try to enjoy the process.
By zane henry
If you are well prepared, you will feel far more confident and you’ll come across as organised and professional. Here are a few must-dos: ■ Find out the interviewer’s name beforehand so that you know whom to ask for at reception and can greet them by name. ■ Make sure you know what you need to bring along. If it’s a portfolio or the like, make sure everything is neatly filed. You don’t want to be left wading through reams of paper, looking for a particular document. ■ Prepare answers to commonly asked interview questions. Questions about your work history and personal questions relating to your skills, values, interests, strengths and weaknesses are bound to come up, and it’s easier to provide an intelligent answer if you’ve given them some thought. ■ Do as much research as you can on the organisation you are hoping to join. The more you know, the better positioned you will be to converse with the interviewer and answer questions.
Don’t get personal
Avoid being overly familiar, and don’t even think of telling that joke you heard at the braai over the weekend. Personal comments or questions and familiar behaviour are unprofessional and will only serve to make your interviewer uncomfortable. That said, you don’t need to leave your personality at
reception. Sincere friendliness, warmth and an appropriate sense of humour can help break the ice and make the interview a more enjoyable experience for both of you.
Avoid the temptation to embroider the truth at all costs. When questioned about your abilities and experience, be completely honest. While it is possible to learn on the job, it’s not a chance worth taking. You can be sure that it will come back to haunt you down the line when you’re asked to take on a task you professed to be fully capable of doing, but are actually clueless about.
Look the part
Many jobs have been lost before they’ve even started by dressing too casually for interviews. Take your cue from the type of business you’re entering and dress accordingly. And go easy on the cologne or perfume.
Never critisise your previous employers
At some point, you will most likely be asked what your reasons are for leaving your previous place of employment. This is not the time to bad-mouth your previous employer – doing so makes you seem like a whiner and smacks of sour grapes. Instead, tell your interviewer that you need a new challenge, want to broaden your skills base, or whatever is true in your case. 25
Bankmed Bounce your World of Wellbeing Summer 2011/12
New year, new job? Make that interview count.
The skinny on underweight In today’s diet-obsessed society, it’s easy to dismiss the dilemma of those struggling to gain weight. But the health dangers of being underweight are just as real as being overweight. By karen nel
Insufficient nutrient intake occurs when someone does not eat, either due to a lack of available food, or due to fear of eating. This can be a psychological
fear, as in the case of eating disorders like anorexia nervosa, or fear of the physical pain caused by eating, for example in those who have peptic ulcer disease or mouth sores. Rapid weight loss also often occurs in the case of drug and alcohol addiction because these substances take the place of food in an individual’s diet. Insufficient nutrient absorption can be caused by a number of conditions, such as inflammatory bowel disease, pernicious anaemia, intestinal parasites, food allergies and autoimmune disorders: ■ Inflammatory bowel disease (such as Crohn’s disease and ulcerative colitis) causes the bowel to become irritated and inflamed, which means that it cannot absorb nutrients properly and most food will simply be flushed straight through the system, causing weight loss. ■ Pernicious anaemia is a form of anaemia resulting from a vitamin B12 deficiency. This occurs when the body fails to absorb vitamin B12 properly, or when the diet does not supply enough of this vitamin. Substantial weight loss can result. ■ Intestinal parasites (such as tapeworm and giardia) live inside
the digestive system and feed on the nutrients consumed by the host. The result is that the host will lose weight despite eating a normal diet. ■ In the case of an allergy to foods such as wheat, cow’s milk protein, egg, soya, nuts, or shell fish, and autoimmune disorders such as coeliac disease, the body perceives certain foods as dangerous and develops an adverse reaction to them. This leads to symptoms such as rashes, wheezing, vomiting and diarrhoea. In the case of coeliac disease, the outer lining of the small intestine becomes damaged and is therefore unable to absorb nutrients. Increased nutrient use occurs as the result of many diseases such as tuberculosis (TB), HIV/Aids and cancer. It can also occur due to an overactive metabolism, for example in the case of hyperthyroidism. ■ Diseases such as TB, HIV/Aids and cancer are often referred to as ‘wasting diseases’ due to the body’s tendency to waste away fat and muscle stores while fighting infection. See box ‘The big three’ on page 28. ■ Hyperthyroidism is a condition in which the thyroid gland, situated just below your voice box, goes into overdrive and produces too many
n an ideal situation, people would only lose weight when they reduced their daily kilojoule intake, or were so active that they used up all the energy they got from their diet. However, a number of health conditions can cause unintentional weight loss. ‘Unplanned weight loss should always be investigated,’ says Cape Town general practitioner (GP) Dr Mark Stodel. ‘Your GP will usually ask about your medical history, give you a thorough examination and might request simple blood tests and X-rays before moving on to more invasive tests.’ According to Dr Stodel, the reasons for being underweight can be divided into three broad categories: insufficient nutrient intake, insufficient nutrient absorption and increased nutrient use.
Bankmed Bounce your World of Wellbeing Summer 2011/12
How do I know if I am underweight? Work out your body mass index (BMI) by dividing your weight in kilograms by the square of your height in metres. For example, 60kg ÷ (1.67m x 1.67m) = 21.5. A BMI of below 18.5 is regarded as underweight. A BMI of below 16 is
regarded as severely underweight and requires urgent medical attention.
What are the risks of being underweight? When someone loses a lot of weight and becomes underweight, the body goes into a state of stress known as a catabolic state. In response, the body produces more cortisone to increase your desire for high-energy nutrients like sweet and salty foods. ‘Cortisone counteracts insulin so that you conserve more energy, but it also mobilises energy stores from the liver and you start to break down fat. Once the fat stores are used up, you use up muscle. Once that is used up, there
the big three In South Africa, the most common causes of illness-induced weight loss are cancer, TB and HIV/Aids. Cancer Patients with cancer have an elevated metabolism due to rapidly growing tumours, which means they burn more kilojoules at any given moment. ‘In response to infection, the body produces high levels of cytokines (signalling molecules secreted by the immune system). Elevated cytokines play a leading role in the pathophysiology and maintenance of malnutrition in conditions like cancer,’ says Roodepoort GP Dr Carina Venter. ‘In addition, cancer medication and chemotherapy can cause nausea and decreased appetite, which further contribute to weight loss,’ she says. TUBERCULOSIS The most evident signs of TB infection are rapid weight loss, drenching night sweats and
productive coughing. ‘Weight loss in TB patients is caused by increased nutrient use due to rapid breathing and a faster metabolism due to mediators released by the body to fight infection,’ explains Dr Stodel. HIV/Aids The causes of weight loss in HIV patients vary, depending on the opportunistic infections involved. Usually weight loss is caused by a combination of factors, including decreased food intake due to symptoms that may impede optimal nutritional intake, for example nausea, mouth and throat sores, chewing and swallowing difficulties, and a general loss of appetite, malabsorption of nutrients due to conditions like chronic diarrhoea and excessive vomiting, and increased metabolism due to the body’s attempt to fight infections.
is little to use and your body starts to shut down,’ says Dr Stodel. If you continue to lose weight, your heart will beat slower and slower and, with not enough blood getting to the organs, they go into failure and death ultimately ensues. However, there are many other risks associated with being underweight even before eventual heart failure. An inadequate diet, or the inadequate absorption of nutrients, can lead to a wide range of vitamin deficiency disorders, such as beriberi (vitamin B1 deficiency), scurvy (vitamin C deficiency), pellagra (vitamin B3 deficiency), rickets (vitamin D deficiency), night blindness (vitamin A deficiency) and, as mentioned earlier, pernicious anaemia (vitamin B12 deficiency). Vitamin deficiencies, in turn, have a negative effect on your immunity. ‘Being underweight makes you far more susceptible to infections such as typhus, cholera and bronchopneumonia,’ says Dr Venter. Severe weight loss can also lead to osteoporosis, where bone mass is lost as a result of the body trying to use calcium in the bones to meet its nutritional needs. Women who are underweight are also likely to stop menstruating. This is known as amenorrhoea and can in time lead to infertility.
How can I gain weight the healthy way? First things first: go and see a doctor to determine what is causing the weight loss. In many cases, if you treat the disease successfully, you will pick up weight without having to change your diet. However, in longterm illnesses such as cancer, TB and HIV/Aids, a revised eating plan will usually be followed alongside treatment. Sometimes weight loss or low body weight are brought on by a seasonal
thyroid hormones. These hormones stimulate the body’s metabolism, leading to a vastly higher metabolism and unintentional weight loss. ■ Chronic Obstructive Airways Disease can cause the body to burn more kilojoules than usual because the patient has to breathe faster to get air into their lungs.
illness, injury, or emotional strain. The same principles for healthy weight gain apply. ‘If you are underweight, chances are good that your body is lacking important nutrients, including vitamins and minerals. Your diet must include nutritious foods to help boost your immunity while at the same time increasing your energy and protein intake to facilitate healthy weight gain,’ says Cape Town clinical dietitian Anel Viljoen. It may be tempting to resort to large amounts of junk food to help you gain weight, however this is the worst thing you can do as you will still be depriving your body of the nutrients it needs. A good rule of thumb for weight gain is to try to add between 2 100 and 4 200 kilojoules to your usual daily diet. ‘It is very important to get these kilojoules from the correct food groups. Of the total energy that you consume every day, no more than 30 percent should be from fats and 15 percent from protein, with the remainder being made up from
complex carbohydrates like brown bread, brown rice, oats, wholewheat pasta and fresh fruit and vegetables,’ says Viljoen. Examples of high-energy healthy foods that you could add to your diet include peanut butter, avocado, bananas, full-cream dairy products, meal replacement drinks, cheese, soya, legumes and lean proteins like fish and chicken. Homemade smoothies are also an excellent way to increase your intake of dairy, nuts and fruit. ‘It’s important to remember that you don’t necessarily need to eat a lot more food – you can simply make the food that you are eating “stronger”. For example, add peanut butter or honey to your porridge and stir cheese spread or extra margarine into your vegetables or casseroles,’ says Viljoen. Viljoen also advises eating six small meals a day rather than three large ones and taking a multivitamin and mineral supplement daily to address any nutritional deficiencies that you might have.
Here’s what you should eat if you have lost weight as a result of ■ pernicious anaemia: If the condition is the result of insufficient vitamin B12 in the diet, eating foods high in B12 will treat it. Good food sources include breakfast cereals fortified with B12; meats such as beef, liver, poultry and fish; eggs and dairy products. Strict vegetarians who don’t eat any animal or dairy products are most at risk, and need to take a vitamin B12 supplement. ■ coeliac disease: Follow a 100 percent gluten-free diet (no wheat, rye or barley) to gain weight and regain your health. ■ inflammatory bowel disease (IBD): IBD tends to have active periods (known as flare-ups) during which symptoms are severe, followed by relatively symptom-free periods (known as remission). ‘During flare-ups it may be helpful to avoid wholegrain products and raw fruit and vegetables. During the remission period, a balanced diet, high in energy and protein with moderate fibre content, is recommended,’ says Viljoen. People suffering from IBD are often lactose intolerant, and need to avoid dairy products. ‘To promote remission of the disease and weight gain, the use of liquid formulas may be necessary. Special attention should also be given to the correction of vitamin and mineral deficiencies,’ adds Viljoen.
Bankmed Bounce your World of Wellbeing Summer 2011/12
e -abled people tell us how they hav
– with a little been able to thrive in the workplace sh help from their friends. by lynne gidi
Cairie Witter (40) Cairie Witter was a prem baby, born at 28 weeks. ’I was given too much oxygen,’ she says, ‘which resulted in torn retinas in both my eyes. I had light and dark perception until my early 20s, but I’ve been totally
Together we can
ife is full of challenges and never more so than when you are differentlyabled. What makes a huge difference is when workplace and medical aid go the extra mile to accommodate your special needs, as these four Bankmed members, all employees of the South African Reserve Bank (SARB), explain.
Cairie has never let her disability stand in her way. SHE admits that Being blind does have its challenges, but with the right mindset and support at home and at work, these can be overcome expenses without any hesitation.’ Which is why, when Carrie got married on her 40th birthday, she insisted that her husband join Bankmed too: ‘They are reliable and they deliver, which gives me great peace of mind.’
Malcolm Lundy (51) Malcolm Lundy has worked at SARB in Pretoria for the past 31 years. He was a clerk for six years before applying for a post in what was then called the Inspectorate Department. ‘I was part of the process that transformed it into modern-day Internal Auditing,’ he explains. In 1994, just before the historic election, Malcolm’s life completely changed when he was involved in a freak incident. ‘I was in a pub, playing pool with a bunch of old friends when one of the guys got involved in an altercation with a security guard, which I had no part in. We left and went somewhere else for one final drink and the guard followed us. As I was paying, he came up to us and lashed out with a whip. The tip went into my right eye, destroying it completely.’ For Malcolm, the months that followed were highly emotional and felt as if they would never end. Aside from the court case that ensued, the married father of two young boys was faced with the biggest health crisis of his life. ‘I’d always been very fit and healthy. I had run a lot of marathons,
including the Comrades, and had done Iron Man. I think my physical fitness carried me emotionally.’ Malcolm’s biggest concerns at the time were financial. ‘When I heard what surgical procedures I needed to undergo, I really worried about the costs, but my doctors liaised with Bankmed and they had no problem covering the surgery my eye specialist planned for me. He removed my existing eye and placed a coral implant the size of a pea in the socket. Coral is porous, so it allows the veins and muscles to grow into it.’ One year later Malcolm had a scan and then his specialist drilled a hole and inserted a prosthetic eye, which is able to move completely naturally. ‘Once again,’ he says, ‘Bankmed came on board and they’ve continued to do so. They cover the prosthetic eye replacements I need to have every two years without any hassles. They truly seem to understand exactly what my needs are, for which I’m really grateful.’
Petro Terblanche (43) An injury at birth resulted in a diagnosis of cerebral palsy for Petro Terblanche, which necessitated her undergoing numerous surgical procedures on her legs until the age of 17. Aside from a problem with her gait that sets her apart from others, she’s never thought of herself as disabled, so it took quite a while to get used to the fact that SARB 31
Bankmed Bounce your World of Wellbeing Summer 2011/12
blind since.’ Cairie has never let her disability stand in her way. With a telephony course under her belt, she worked as a telephonist at Groote Schuur Hospital for eight years before joining SARB in September 1999. Cairie admits that being blind does have its challenges, but with the right mindset and support at home and at work, these can be overcome. For the past 12 years she’s been the voice of SARB’s Cape Town branch, the first person anyone speaks to when they call. Fiercely independent, she is a familiar sight at Parow station, where, with her guide dog Tia, she hops onto the train each day, then walks the few blocks to her office. The bank pulled out all the stops for Cairie when she was employed, purchasing a computerised switchboard with a special speech programme called JAWS (Job Access With Speech), which is essentially a screen reader that’s made her job a whole lot easier. Tia has been welcomed in the workplace, says Cairie, ‘although initially people were a bit wary and a bit concerned about how the two of us would turn out! But they soon realised that I’m exactly the same as everyone else, except for the fact that I can’t see! Bankmed, however, sees me just like everyone else – there are no extra costs involved because of my disability. I’ve been extremely healthy all my life and the first time I had to call on them was for a tonsils operation in 2007. They were really helpful. My doctor wanted me to stay in hospital for a few extra days because he was worried that I may not be aware of any bleeding before it was too late, and Bankmed covered all the
asked her to head up the in-house disabled support group to help with medical liaison. ‘I grew up in a family where I was treated exactly the same as my siblings and, except for spending more time with my mother, I was certainly never regarded as being “different”.’ Petro attended a regular school, then qualified as a teacher before getting her Master’s degree in Northern Sotho. She joined SARB in 2001 as a client liaison officer and describes the support she’s received from both the bank and Bankmed as ‘absolutely incredible’. ‘Then, six years ago, I started struggling to walk in open spaces and I would suddenly freeze when I had to go and see clients in the bank. I went to a neurologist, which the bank paid for, who prescribed physio and, more recently, muscle relaxants, which both help. Ever since then, the bank has allowed me to see a physiotherapist twice a week during working hours and they share the cost of this with Bankmed. We have a gym here at work, but there’s no heated pool, something that does wonders for my body, so the bank pays my annual fees at a gym that has one, for which I feel so very privileged.’ Bankmed too has always delivered when she’s needed them. Petro still occasionally freezes up, probably due to damage to the part of her brain that affects her muscles. ‘When it happens,’ she laughs, ‘I just grab onto one of the wonderful people I work with and hang on until my muscles relax and I’m able to walk on my own again.’
Chris Henning (53) Chris Henning believes that he was born with a loss of hearing 32
WHAT’S YOUR BANKMED STORY? Tell us how Bankmed has helped you or been a part of your life. Send a brief outline of your story to: The Editor, PO Box 15054, Vlaeberg, 8018, or email: firstname.lastname@example.org. Please remember to include your name as well as your contact details.
(bilateral severe sensory neural hearing loss), which deteriorated over the years. ‘I remember always needing to sit at the front of the class at the regular schools I attended and learning to lip-read very early in life. I was taken for hearing tests and was told to wear hearing aids, but being young and self-conscious I refused to do so. After all, I could still cope.’
‘we have a gym here at work but there’s no heated pool – something that does wonders for my body – SO the bank pays my fees at a gym that has one, for which I feel so very privileged’ Things changed when he got to university. ‘The lecture rooms were very big and I realised I was missing a lot of what was being said. My future wife changed my life by convincing me that she’d still love me even with hearing aids, so I got my first pair.’ Chris joined the Reserve Bank 20 years ago as a mechanical technician and gradually moved up the career ladder to his current position as Engineering Operations Manager. Despite his hearing loss, he has never regarded
himself as disabled and admits to using delaying tactics when the bank insisted that he put in an application as a person with a disability when they updated their systems. ‘I’ve always regarded myself as the same as everyone else, aside from the fact that sometimes my speech isn’t up to standard, and hated the idea of being singled out. I had to go for a hearing assessment, which I hadn’t done for a long time, and was shocked at the deterioration – an 86 percent hearing loss. The specialist told me to prepare myself for even more loss, cautioning me that within three years I may lose my hearing completely. But six years later, I’m still able to do my job, attend meetings and answer phone calls. The bank has organised an inline audio booster as well as a special telephone with caller ID for me, which both help a great deal.’ Bankmed has also come to the party over the years, says Chris, especially when he was unable to afford the hearing aids he needed. ‘The aids are extremely expensive, last for only five to seven years and, with technology constantly changing, they can’t really be repaired. Thankfully, I am now in a position where I can afford to buy them, but I remember drafting a letter to Bankmed once, asking for assistance. They agreed to help, which I really appreciated.’
watching their diet, The holidays are tough for anyone enjoy the celebrations including diabetics. Here’s how to without compromising your health.
hen we’re on holiday we tend to relax and ‘let go’ a little. That’s what holidays are all about, right? While that might sound harmless enough, the reality is that eating whatever we feel like, drinking too much alcohol and being largely inactive is unhealthy at best, and downright dangerous if you have diabetes. Medication alone cannot regulate blood sugar levels: lifestyle, and especially diet, is just as important as your meds. But it’s still possible to enjoy holiday celebrations when your diet needs special consideration – it’s all in the planning.
Holiday helpers The good news is that you don’t have to get it completely right all of the time. Jeske Wellmann, registered dietitian
By melanie farrell
and co-author of Snacks and Treats for Sustained Energy, says, ‘It’s best to apply the 80/20 principle: 80 percent of the time you do things 100 percent and the rest of the time you can relax the rules a little.’ This rule will help you to practise moderation with your holiday eating. Ina Van der Merwe, dietitian based in Pretoria, says, ‘When you go overboard and your blood sugar is out of control, it can spoil the holiday because you will feel sick and you can end up in hospital. The key is to spread out meals and snacks evenly during the day – and never skip meals.’ Wellman and Van der Merwe agree that diabetics will benefit from having a personalised eating plan drawn up by a nutritionist or dietitian who can factor in specifics such as age, activity level and dietary preferences. However, there are some general guidelines that will stand you in good stead during the season of overindulgence.
Party time! The cocktail party is a favourite at this time of the year, guaranteeing all manner of kilojoule-infused canapés and snacks. Wellmann advises seeking out party foods and snacks that 34
provide nutrients, not just kilojoules. ‘Most snacks are high in kilojoules with very few nutrients. For example, chips are very high in unwanted transfatty acids,’ says Wellmann. Nuts are a better option, as they contain the more beneficial monounsaturated fats. Portion control is still important, because they are high in kilojoules, so don’t exceed a quarter cup a day. ‘If there are vegetable sticks on offer, have those dipped in hummus, or opt for lower-GI savoury biscuits with lower-fat cheese or other lower-fat
Happy hour Everyone enjoys a tipple or two during the holiday season, but alcohol is loaded with empty kilojoules and can wreak havoc with your blood glucose levels, so it’s important to drink smart. Eat something beforehand, and never
alcohol is loaded with empty kilojoules and can wreak havoc with your blood glucose levels, so drink smart
overdo it – the limit for women is one unit of alcohol (roughly equivalent to one drink) and for men it’s two units. ‘A glass of dry wine or a 30ml tot of whiskey with water is a good choice,’ says Van der Merwe. Avoid cocktails, beer, ciders, sweet wine, sherry and port liqueurs, and never drink alcohol with a sugary mixer, says Wellmann. Even tonic water is high in sugar.
The boerewors blues South Africans love to braai, but typical braai fare – a fatty piece 35
Bankmed Bounce your World of Wellbeing Summer 2011/12
toppings,’ says Wellmann. Better yet, take a diabetes-friendly snack along so that you know there is at least one thing you are able to eat. The worst you can do is end up grazing on sausage rolls, samoosas and cake.
A selection of low-GI loaf cakes, from front: fruit loaf cake, chocolate loaf cake, banana loaf cake and carrot loaf cake. Recipes from Snacks and Treats for Sustained Energy (Tafelberg) by Gabi Steenkamp (RD) SA and Jeske Wellmann (RD) SA.
salad, or roasted vegetables, and some low-GI bread to fall back on if the buttery garlic rolls start calling your name. ‘Avoid puddings, ice cream and custard,’ says Van der Merwe. ‘Have fresh fruit if it’s on offer, or take along some fruit for dessert.’
If you do go a little overboard, the important thing is to not be consumed by guilt and immediately go back to your meal plan of meat or wors, and refined carbohydrates such as chips and white bread rolls – are not going to do your blood sugar levels any good. ‘A braai is just another meal,’ says Wellmann, ‘and should be treated as follows: fill half your plate with vegetables and salad, have a fistful of starch – preferably low-GI starch such as wholegrain bread or baby 36
potatoes with their skins – and a palm-sized portion of red meat or chicken with all fat and skin removed. Beware of the fat that’s hidden in certain foods, such as the dressing on salads, and if you don’t know what’s in a dish, rather avoid it. The big advantage of the bring-and-braai is that you get to take what you want to eat with you, so take along a healthy
If you have a sweet tooth, the festive season can be a killer with all the cakes, puddings and chocolates on offer. Jeske maintains that moderation and being selective are key. ‘Certain snacks will help control blood glucose levels much better and also offer health benefits – fresh fruit kebabs with yoghurt dip, for example, are a good alternative to high-fat, white-flour desserts. However, such options are not always on offer, in which case you can have a very small portion of the dessert, scraping off any cream,’ she says. Van der Merwe recommends using artificial sweeteners and sugar-free cold drinks, and having a diabetic chocolate or other diabetic sweets when you need a treat. Just bear in mind that diabetic chocolates have the same fat content as regular chocolate, so don’t see it as an excuse to eat too much. ‘Try to keep snack portions small and never go overboard,’ she says. ‘If you do go a little overboard, the important thing is to not be consumed by guilt and immediately go back to your meal plan. This will minimise the damage.’
No-one is perfect and there will probably be times when, despite your best intentions, you slip out of your healthy eating and exercise routine. It’s important to get the situation under control as soon as possible to avoid the two main problems associated with diabetes that is not properly regulated: hypoglycaemia and hyperglycaemia. Dr Geoffrey Parker, a specialist physician based at Life Mercantile
eating out Restaurant meals can be a minefield. Van der Merwe offers these tips: ■ When it comes to the starter, opt for a thin soup or light salad, or forgo this part of the meal altogether. ■ Pass on the complementary bread and butter. ■ Have grilled chicken or fish for your main meal, or consider a low-fat vegetarian option if one is available. ■ Pass on the rich sauces, which are usually high in fat. ■ Salad dressings are generally kilojoule bombs. Enjoy a drizzle of olive oil over your salad instead. ■ Request a baked potato or rice rather than chips. ■ Choose dry wine over the sweeter varieties, which have a greater effect on blood glucose levels, and stay away from liqueurs. ■ Skip the dessert. End off your meal with a black coffee instead. ■ Drink water with your meal, eat slowly and savour your food. You’ll find the meal will go further and you’ll be much less inclined to overdo it.
Hospital, says, ‘On the simplest level there are three factors that determine blood glucose levels: 1. Meals – these tend to raise blood glucose levels. 2. Treatment – this tends to lower glucose levels. 3. Exercise – this also tends to lower glucose levels. ‘When there is a disruption in this balance, the glucose may rise or fall.’
Dealing with hypoglycaemia Hypoglycaemia occurs when your blood sugar level is too low. It is important that you check your blood whenever you feel low blood glucose coming on. If your blood glucose level is indeed low, you need to treat the hypoglycaemia quickly. Symptoms of hypoglycaemia include the following: ■ Shakiness ■ Dizziness ■ Sweating ■ Hunger ■ Headache ■ Pale skin colour ■ Sudden moodiness or confusion ■ Behaviour changes ■ Clumsy movements ■ Seizure ■ Difficulty paying attention ■ Tingling sensations around the mouth. The quickest way to raise your blood glucose and treat hypoglycaemia is with some form of sugar, such as glucose tablets, which you should keep with you at all times. Once you’ve checked your blood glucose and treated your hypoglycaemia, wait for 15 to 20 minutes and check your blood again. If your blood glucose is still low and the symptoms of hypoglycaemia don’t go away, repeat the treatment. When you are feeling better, make sure you eat your regular meals and snacks as planned to keep your blood glucose level up. It’s important to
treat hypoglycaemia quickly because it can get worse and you could lose consciousness. If you pass out, you will need immediate treatment, such as an injection of glucagon or emergency treatment in a hospital.
Hyperglycaemia Hyperglycaemia is the technical term for high blood sugar. It occurs when the body doesn’t have enough insulin, or is unable to use its insulin properly, to regulate blood sugar levels. Symptoms of hyperglycaemia include the following: ■ Increased thirst ■ Frequent urination ■ Fatigue ■ Blurred vision. High blood sugar levels can be dangerous, especially if prolonged. If your blood sugar levels are high, it is important to drink water, increase your level of exercise and pay attention to your diet. If your blood sugar level does not normalise, or it increases, contact your healthcare provider. ‘I suggest that all diabetics visit their healthcare provider before going on holiday to discuss strategies should they develop warning symptoms of hyperglycaemia,’ says Dr Parker.
The Bankmed Special Care Programme for diabetes offers members diagnosed with diabetes information, guidance and assistance. For more information, call 0800-BANKMED (0800226-5633), or send an email to email@example.com.
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WIN a getaway with a difference Ever ‘held hands’ with an elephant? At The Elephant Sanctuary you can get up close and personal with these magnificent animals. The sanctuary is a family-orientated operation that provides a safe haven for African elephants and an opportunity for guests to learn more about them in beautiful, lush surroundings. Guests
are guided in small groups on foot through the forest and get to touch, feel, feed, walk trunk-in-hand and even ride these gentle giants. Elephants are highly intelligent and delightful, each with a distinct personality and temperament, and interacting with them is a truly remarkable experience.
We are giving two couples the opportunity to win a weekend getaway to The Elephant Sanctuary at Hartbeespoortdam. The prize includes breakfast, dinner and the Elephant Programme.
How To be in line to win, SMS the words Bounce/Elephant Sanctuary with your full name, daytime phone number and the answer to the question below to 34509 by 31 January 2012. The cost per sms is R2.
Question: How many Wellness and Preventative Care Benefits are there in the Bankmed 2012 Benefit and Contribution Schedule? Clue: You’ll find the answer to this question on pages six and seven of the schedule.
COMPETITION RULES AND CONDITIONS The competition is open to Bankmed members only. This prize is not transferable, cannot be redeemed for cash and is strictly subject to availability. This prize is valid until 30 April 2012. It excludes flights, meals not expressly stipulated, beverages, gratuities and all other items of a personal nature. Winners will be randomly selected, notified by telephone and their names will be published in the magazine within four months of the competition’s closing date. The judges’ decision is final and no correspondence will be entered into. Bankmed and The Elephant Sanctuary, its owners and its employees assume no liability for loss or damage arising from participation.
Bankmed Bounce your World of Wellbeing Summer 2011/12
Experience the elephant adventure of a lifetime
holiday blues H Do you dread the holiday season? Youâ€™re
not alone. Make this year different by putting preventive measures in place to counter that end-of-year slump. By catherine eden
olidays are supposed to be about fun and celebration, yet for many people the festive season is anything but happy. Cassey Chambers, operations director of the South African Anxiety and
Depression Group (SADAG), says their counsellors receive an average of 400 calls a day all year round, but issues relating to loneliness, depression and family relationship tensions do become more prominent at this time. There are many reasons for our
Great expectations If we were to question those apparently joyful family groups we might be surprised to learn that the picture is not as rosy as it appears. We have an idealised notion of how family gatherings are supposed to be, points out Johannesburg-based psychologist Christo Van der Westhuizen, and are disappointed when our own experience fails to live up to the movie ideal or softfocus memories of magical childhood holidays. ‘The reality is that family relationships are complicated and often stressful,’ he says. The tricky dynamics that are always there don’t evaporate just because you’ve packed the car and are headed for a week at the coast. If anything, they’ll flare up even more as each person tries to meet their expectations of having a good time. It’s even harder to enter into the festive spirit if you associate this time of year with the loss of a loved one and find yourself grieving all over again, wishing that they were there to share in family time, says Randburg life coach Dr Christine Boon. Guilt
that you are spoiling the mood for everyone else then compounds your gloom, guaranteeing that your celebration will have about as much fizzle as flat champagne. ‘Keeping feelings bottled up is a very bad idea and can make matters so much worse’, says Van der Westhuizen, ‘so face what is bothering you and if you are depressed, get help before the holidays roll around.’
Communication is key The logistics involved in planning the end-of-year break can spark discord in the most harmonious of households. The nature and definition of ‘family’ is changing, and with so
Don’t take on more than you can manage, and even then ask for help WHEN you need it and share the load
many permutations it is difficult to take everyone’s needs into account. Start talking about your plans well in advance, so that you can iron out the issues of where (and with whose extended family) to spend Christmas. Consider whether you really have to be steamrollered by certain traditions that might no longer work for you. Your idea of a relaxing break might be an ordeal for your partner. Discuss your preferences and reach a compromise so that you can avoid resentment and sulks when you are huddled over a damp fire in the middle of nowhere. The demands of controlling family members can be overwhelming, so discuss a defence strategy and enlist your partner’s help in being firm about what you are willing to do. Don’t take on more than you can manage, and even then ask for help and share the load. Tell uncle Willie that he can’t park his caravan on your lawn this year and suggest that someone else hosts the big family dinner if it always falls to you. Aim to do your bit, but resolve not to be a doormat or a martyr this year. (See article ‘Say Yes to No’ on page 18 for tips on how to say ‘no’.)
Do a reality check
need support? SADAG counsellors are on duty seven days a week from 8am to 8pm, Christmas, Boxing and New Year’s days included. Call their toll-free helpline number: 0800-21 22-23, or visit www.sadag.org.
‘Often, the blues we feel at holiday time have more to do with anxiety than sadness,’ explains Dr Boon. A big slice of this anxiety relates to overspending and financial strain. Relentless advertising seduces us into a frenzy of shopping, so keep a check on the madness of materialism by setting – and sticking to – a reasonable budget. Is it worth going into debt to buy those expensive gifts or fund that trip that you can’t afford? If money is tight, be creative about Christmas presents. Set a price limit that everyone in your extended family must adhere to, or challenge everyone to come up with the most inventive gifts they can, spending no more than 41
Bankmed Bounce your World of Wellbeing Summer 2011/12
heightened susceptibility to holiday stress. Traditionally, this is a time of togetherness, so for people who live alone or far away from relatives, it can be really difficult to see ‘happy’ couples and ‘perfect’ families planning their holidays in the knowledge that yet again they have nowhere to go and no-one to be with. The solo life, manageable during the busy routine of the working months, suddenly seems desperately unfulfilling and empty when measured against everyone else’s exciting prospects.
to boost our own happiness is to bring happiness to someone else, so do something to spread a little good cheer via any of the countless organisations that serve the vulnerable and disadvantaged. ‘This is also a time to practise tolerance and forgiveness,’ says Dr Boon. ‘If certain family members embarrass you or are always critical of you, accept that you cannot change them. If you know what to expect, it’s easier not to react when they behave true to form. It can be a difficult time of year, but know that you are not alone. Millions of people around the world are feeling exactly the same way as you.’
Practise peace and goodwill
If you don’t have family, appreciate the fact that you have the freedom to do
The festive season is supposed to be about generosity and sharing. We all know that one of the best ways
Do something different
make it work for you New Year’s Eve is often the most difficult day of the year, especially for the single. Party-time glitz is tarnished by nostalgia and sadness for the passing of another year, especially if you are berating yourself for having got to December again without finding that relationship you long for, or without having achieved last year’s resolutions. For 45-year-old Janice, who has been single for five years, the worst moment is when the clock strikes 12 and all the couples fall into each other’s arms, reaffirming their love and commitment to walking the road
of life together. ‘I feel so alone, I can’t stand it,’ she says. If this resonates with you, don’t put yourself through the torture of another New Year’s Eve party. Claire, 50, says, ‘I’ve done the party thing and I hate it. I’ve tried ignoring New Year and staying home with a book, but that’s almost more depressing. So now I find a friend who is also at a loose end, we dress up and go out to dinner and the theatre. We do something special to mark the occasion and are happy to be safely back home before the drunk drivers are out on the road.’
The Bankmed Personal Stress Assessment (PSA) can help you assess your mentalhealth status. Bankmed Vitality members can earn up to 5 000 points for completing the PSA. The Bankmed Special Care Programme for depression offers support and guidance to members diagnosed with depression. For more information, phone 0800BANKMED (0800-226-5633).
as you choose. Take a day trip, book a tour, or plan some indulgence that is a treat for you. Being alone is not the same as being lonely. ‘Paradoxically, loneliness has little or nothing to do with how much time people actually spend by themselves, nor how many social contacts they have in a given day,’ writes Daniel Goldman in Social Intelligence (Random House). ‘What matters is the quality of our interactions: their warmth or emotional distance, their supportiveness or negativity.’ In the interest of reaching out, consider finding out who else is on their own over the holiday season and invite them to a gathering at your house. If all else fails and you are destined to spend a lot of time on your own this holiday season, tackle a big project that absorbs you. It is almost impossible to feel miserable when you are involved in a creative activity. This might be the time to paint that mural or write that screenplay. Before you know it, it will be January and time to complain about having to go back to work.
R20 on each. Or agree that each adult contributes a single good-quality gift, so that there is just one parcel for each person under the tree. Be aware that the perception that other people are having a better time is often an illusion. Decide what’s important to you about the festive season and how best you can help to make it meaningful. Remember that any emotional stress you carry tends to be magnified over the holiday period and is exacerbated by your physical state. ‘We eat too much, exercise too little, have less sleep, and try to fit all our planning and activity into too short a time,’ says Dr Boon. So assess your mood and do what you can to find balance and contentment in the midst of the festive mayhem.
on fertile ground I
t can be frustrating when it seems that everyone around you is having a baby and you’re the only one who can’t fall pregnant. Here is some expert advice on how to maximise your chances of conception – and set yourself up for a healthy pregnancy right from the start.
The lifestyle connection Your lifestyle choices are among the most important factors in conception. Good habits will not only help you conceive, but will also serve you and your baby well during pregnancy and after birth. ‘A healthy lifestyle is critical because it helps get your body into a balanced state,’ says pregnancy educator Tina Otte. If you are compromised in any way, both you and your child could be affected. As the vehicle that brings a precious new life into the world, mothers
play an integral part in the healthy development of their child’s brain and physical body. ‘If we start preparing when we are already pregnant, it’s almost too late. We need to start before conception,’ says Otte. Take these lifestyle factors into account: ■ Maintain a healthy weight: Obesity is associated with infertility, and many studies have shown that weight loss increases a woman’s likelihood of conceiving. Being overweight can mean you’re more prone to complications and wire your baby to have problems with obesity, diabetes and other metabolic diseases later in life. ■ Get active: Moderate exercise is a great way to lose weight and condition your body for the physical challenges of pregnancy. If you’re fit you’ll also be able to shed extra kilos more easily after the birth. ■ Eat well: All your body’s processes work better when they are fuelled by good, wholesome foods. Fruit, vegetables, wholegrains and calciumrich dairy products are recommended. ■ Limit caffeine: Some studies suggest that excessive caffeine can interfere with conception. Play it safe and don’t exceed two cups of coffee per day. ■ Keep stress under control: High levels of adrenalin are not healthy and certainly not helpful for conception. Consider calming exercises and relaxation techniques to ease your worries, suggests Otte.
The age factor Your chances of conceiving are also highly dependent on your age and, to a lesser extent, the baby’s father’s age. According to a study published in the journal Human Reproduction, the probability of pregnancy in women aged 19 to 26 years was 50 percent; in those aged 27 to 34 it was 40 percent; and in those aged 35 to 39 years, it was about 30 percent.
Timing is everything Provided that you and your partner are both healthy and there are no medical reasons that you can’t make a baby,
nces of Trying for a baby? Improve your cha . By joanne lillie conception with these essential tips
■ Don’t smoke: Smoking may increase the risk of miscarriage and deprive your developing baby of oxygen and nutrients. Up to 13 percent of sub-fertility has been attributed to cigarette smoking, according to studies in the journal Fertility and Sterility. Heavy smoking (more than 10 cigarettes a day) is also associated with higher chances of miscarriage, confirms a study in the New England Journal of Medicine. It’s important to note that a father who smokes may also increase the risk of pregnancy loss. ■ Don’t drink: Alcohol is off-limits if you’re planning a pregnancy because it’s a known teratogen (an agent that causes embryo malformation) and it has not been established how much, if any, is safe in pregnancy. ■ Don’t take medication without your doctor’s consent: Certain drugs, even those available over the counter, can make it difficult to conceive. Others may not be safe once you’re pregnant. ■ Start taking folic acid: A prenatal vitamin with folic acid can reduce the risk of certain birth defects.
Bankmed Bounce your World of Wellbeing Summer 2011
Provided that you and your partner are both healthy and there are no medical reasons that you canâ€™t make a baby, timing really is everything
Baby-and-me Baby-and-Me is Bankmed’s Special Care Programme to inform and empower expectant moms and dads during pregnancy. Register now to access additional insured benefits during your pregnancy. You can request an application form to register by sending an email to babyandme@ bankmed.co.za. You can also visit www.bankmed. co.za or contact the Bankmed customer call centre on 0800BANKMED (0800-226-5633). varies with the length of the cycle, but the interval to the period after ovulation is relatively constant. If your cycle is very irregular or frequently shorter or longer than this, it’s best to consult your gynaecologist because you may not be ovulating. ‘A good rule of thumb is to have intercourse every two to three days from the length of your shortest cycle minus 16 days, to the length of your longest cycle minus 14 days,’ says Dr Zinn. For example, if your shortest
A healthy start A pre-conceptual assessment is a good idea for every woman planning pregnancy, but essential for women with medical problems, particularly when taking medication, to optimise your health before falling pregnant, advises Dr Zinn. This will also be an opportunity to confirm that you are immune to Rubella (German measles) and Varicella (chicken pox), which can both seriously harm your unborn baby. If you need to be vaccinated, you will be asked to avoid
pregnancy for three months. Once pregnant, staying healthy requires regular antenatal visits for screening and early detection of potential problems. Your first antenatal visit will allow a comprehensive health and risk assessment to individualise the approach to antenatal care. ‘Some screening tests take place in the first trimester and depend on your gestational age, so early booking to allow accurate dating and timeous discussion of screening options is important,’ says Dr Zinn.
typical cycle is 26 days and your longest typical cycle is 30 days, then the range for intercourse would be 26-16 to 30-14 = days 10 to 16 are the best for conception. In a regular 28-day cycle, it would be days 12 to 14. Once released, the egg lives for 24 hours, but only the first 12 hours offer a high chance of fertilisation. Fortunately, healthy sperm easily last for three days and as long as six days. As time passes after intercourse, the concentration of sperm in the fallopian tubes (where fertilisation takes place) decreases, so decreasing the chance of a sperm finding the egg. If you have not fallen pregnant within 12 months of trying if you’re under 35, or within six months if you are over the age of 35, you should discuss your fertility with a specialist.
How much is enough? The highest pregnancy rates occur in couples who have sex every one to two days, according to research published in the New England Journal of Medicine. But regular intercourse two to three times a week, starting soon after the end of a period, should ensure that you’re within the fertile period and that semen quality is optimal.
timing really is everything. In a 28-day cycle, ovulation takes place on day 14, usually in the late afternoon. The best time for conception is that evening, explains Dr Philip Zinn, an obstetrician and gynaecologist in private practice in Cape Town. The length of regular ovulatory cycles may vary between 25 and 35 days. If your cycle varies in length, ovulation typically takes place 14 days before the first day of the next period. In other words, the time of ovulation
The danger of OTC drugs ter drugs are You may think that over-the-coun y may just the least of your problems, but the pose the greatest threat.
Paracetamol Paracetamol/acetaminophen is a widely used OTC pain reliever and fever reducer. While generally safe for use at the recommended dose, acute overdoses can cause fatal liver damage. Excessive consumption has also been linked to asthma, eczema, blood cancer and kidney damage.
Aspirin Research shows that people who take low doses of aspirin to protect their heart have an increased risk of gastric
bleeding that is almost twice that of people who don't. Those who take aspirin as well as other common drugs may have an even greater risk of bleeding. A study done in California has also linked aspirin with erectile dysfunction. While the researchers believe that other factors, like smoking, advanced age and diabetes, also played a part, they maintain that aspirin, taken to cure other problems, could have exacerbated the problem. Always discuss the use of aspirin with your GP and weigh up the pros and cons. Never self-medicate.
Dextromethorphan (DXM) DXM, found in various cold, flu and cough medicines, triggers hallucinogenic episodes when taken in high doses. For this reason it has gained popularity among teens, who use it for recreational purposes. The abuse of this drug has many harmful side effects, including fever, impaired vision, irregular heartbeat, increased blood pressure, rapid breathing, diarrhoea, vomiting, impairment of mental processes, memory loss and coma. DXM can be fatal when used with other medicines or narcotics and several DXM-related deaths have already been documented. Make no mistake – this is a dangerous and deadly syrup.
Caffeine Caffeine is used in numerous OTC medicines. It has many unpleasant side effects when taken in high doses: ■ Caffeine interferes with a tranquilising neurotransmitter chemical in the brain called adenosine, resulting in stress, anxiety, depression and insomnia. ■ It is highly addictive and causes unpleasant withdrawal symptoms. ■ Excessive consumption could make conception more difficult and cause low birth weight in babies. ■ It has a diuretic action, resulting in more frequent urination. This can lead to depletion of important nutrients. ■ There appears to be a link between excessive caffeine consumption and miscarriage. Be aware of the dangers lurking in your medicine cabinet. Read your OTC medicine ingredient label and lock the cabinet door. For more medicine safety tips, read 'Medicine Cabinet Must-Haves' on page 48. For medical advice in emergency situations, call Netcare 911. They can provide telephonic assistance until a medical team arrives. 47
Bankmed Bounce your World of Wellbeing Summer 2011
e tend to assume that medications that can be obtained over the counter (OTC) are generally less harmful than those that require prescriptions, and are far less worrying than street drugs, but don’t let the fact that OTC drugs are easily obtainable lull you into a false sense of security. The latest findings reveal that, together with prescription drugs, OTC drug abuse among teens is a bigger threat than cocaine use. Besides being highly addictive, some of the most common OTC drugs used to relieve headaches, coughs, fever, sleeping problems and anxiety contain substances that are hazardous to your health when taken in excess. Here are a few common OTC drugs and the potential dangers associated with them.
must-haves Make sure your medicine cabinet and first-aid box are well equipped to deal with ailments and accidents during the holiday season. By michelle pentecost
he extended family is down for the holidays. In between feeding the masses and entertaining the in-laws, there are the inevitable medical mishaps: little Johnny grazes his toe, Gran is coming down with a cold, Uncle Tom is allergic to the cat. Opening the neglected medicine cabinet reveals a few tired old bottles of expired pills and a plaster that isn’t sticky anymore.
Stocking the medicine cabinet Art van Duuren, a pharmacist based in Cape Town, advises that you stock your cabinet with a variety of medicines that you may well need at night, when the pharmacy is closed. Go straight to your GP for anything serious, but for everything else, have these items readily available: Pain medication ■ Paracetamol remains the safest choice for pain relief in all age groups. 48
‘Remember that you’ll need to have paracetamol syrup on stand-by if you have little ones, while tablets are fine for adolescents and adults,’ says Van Duuren. Paracetamol is not always the GP’s choice, however. Dr Shelley Hellig, a family physician based in Paarl, always reminds her patients that an overdose of paracetamol can be fatal. These pills must be stored
In case of emergency Add your local emergency numbers to this list of national ones and tack it onto your medicine cabinet or first-aid box for easy access: ■ Ambulance services: 10177 ■ Red Cross Hospital Poison Line (24 hours): 021-689-5227 /0800-33-3444 ■ Police Flying Squad: 10111 ■ Netcare: 911
way beyond the reach of children and adolescents. ■ Nonsteroidal anti-inflammatories such as ibuprofen are another option in cases of inflammatory pain such as period pain, lower-back pain or toothache, but these can interact with certain chronic medications. ‘They should also be avoided in patients with a history of gastrointestinal ulcers,’ says Dr Hellig. ■ Aspirin is a must-have. ‘Any adult who develops severe chest pain or shows the early signs of a stroke (limb weakness, facial drooping, slurred speech) should chew two aspirin tablets at home before transfer to the emergency unit,’ says Dr Hellig. However, note that aspirin should never be given to people who use blood-thinning medication, or to children under 16 years, who may develop Reye’s syndrome, a rare but potentially fatal illness. Antacids Overindulging at the buffet table can lead to heartburn and indigestion. ‘For occasional heartburn, a liquid antacid preparation provides relief, but anyone who has recurrent symptoms should be investigated. This kind of pain may be secondary to gastric ulcers or an underlying heart condition,’ says Dr Hellig. Antihistamines Exposure to pollen, or to your relative’s pets, can cause a mighty flare-up of hay fever. Keep a stock of antihistamines that are nonsedating. Treating colds A nasal decongestant containing chlorpheniramine and phenylephrine will help with the sneezing, nasal itching and runny nose that are common to the cold. An expectorant
cough medication is useful for mobilising excess mucous out of your chest, but if you have a persistent cough it may be better to see your GP.
Treating rashes and bites Calamine lotion will soothe the itch of anything from insect bites to chicken pox. A one-percent hydrocortisone cream may be handy for itchy rashes that are not responding to this treatment. For fungal infections such as athlete’s foot, an antifungal cream or spray is worth keeping in the cupboard.
The essential first-aid kit Don’t leave for the family vacation without a compact first-aid kit in the boot so that you’re equipped to deal with minor cuts and scrapes, or larger wounds while you await medical assistance. Make up your own kit, or simply buy a pre-assembled version. Essential items include: ■ A few pairs of gloves. You never
know when you may need to assist someone else and there might be blood. Protect yourself first. ■ Sterile gauze and dressings, plasters and bandages. Stock up on a few sizes for dressing small abrasions, or for applying pressure to arrest bleeding. ■ Burn dressings. Always first run cold water over a burn and seek medical assistance for anything more than first-degree burns. ■ Antiseptic ointment and alcohol wipes for the cleaning and dressing of wounds.
■ A thermometer. ■ A pair of scissors. ■ Tweezers, for removing splinters. ■ Cold gel packs, for treating sprains and knocks. ■ A compact blanket. ■ Sterile water or wash for rinsing out eyes and disinfecting wounds. Netcare 911 provides telephonic medical advice and information for emergency situations. Call them for immediate assistance in the case of illness or injury until a medical team arrives at the scene.
Safe keeping Ensure your medicine cabinet is a help, not a hazard: ■ ‘Store medicines in a locked cabinet and in child-proof containers,’ says Dr Hellig. Tablets look like sweets to children, and accidental overdose is a potentially fatal yet entirely preventable event. ■ Keep medicines in their original packaging and store them in a cool, dry area, or according to the instructions on the package.
■ Check expiration dates and discard old medicines, but not in your bin, where others may find and use them. Rather hand them in at your local pharmacy for appropriate disposal. ■ Avoid drug interactions. If you are on chronic medication, make sure that any over-the-counter medication you take is safe and will not interfere with your usual medication.
Bankmed Bounce your World of Wellbeing Summer 2011/12
Treating tummy troubles Make sure you have loperamide on hand to stop diarrhoea. For relief from nausea or vomiting, Dr Hellig recommends having stemetil suppositories on stand-by. For little ones, medication for diarrhoea or vomiting is a no-no. Rather make up an oral rehydration solution by combining one litre of clean water with one level teaspoon of salt and eight level teaspoons of sugar. Allow the child to drink this throughout the day to stay hydrated. ‘Pre-made rehydration sachets are also available at most pharmacies,’ says Van Duuren. If the child isn’t drinking or the condition is persistent, you’ll need to head to your GP.
Ditch those bad relationship habits and enjoy a more fulfilling and rewarding partnership in 2012. By robyn maclarty
ad relationship habits are sneaky. They creep in through the back door and by the time you notice them, they’ve already wreaked havoc on your once-bulletproof partnership. Here are six New Year’s relationship resolutions to help you break the most common bad habits.
Relationship resolution no
Don’t look for faults Dr Phil says it best: ‘There is nothing wrong with constructive criticism if it is designed to improve the relationship. But it can often give way to constant fault-finding in which you obsess over the flaws and imperfections rather than find value in your partner.’ Whoever we spend time with will undoubtedly have faults, and successful relationships require a certain tolerance of the other person’s weaknesses. If we keep picking up on the faults of our partner, expecting them to change, we create permanent tension. Not only that, we send the message to our partner that they are not good enough, no matter how hard they try. Often, we’re not even aware that we’re doing it – or, if we are, we feel justified. The next time you open your
mouth to criticise your partner, stop to ask yourself if it’s really for the good of the relationship. If not, hold your tongue – it’s a relationship saver! If you feel you really do need to address the issue, try phrasing your concerns as ‘I’ statements instead of ‘You’ statements. For example, ‘You are so inconsiderate’ could be rephrased as ‘I sometimes feel you don’t want to spend time with me when you go out with your friends all night/work late/ make plans without consulting me.’ This opens up a dialogue and is less likely to inspire defensiveness.
Relationship resolution no
Practise random acts of kindness We think we’ll give him that welldeserved back rub, or take the kids out so she can enjoy a child-free afternoon, but somehow it gets put off. ‘I used to do little things for my husband all the time before the kids were born,’ says Niki, 44. ‘I’d buy his favourite ice cream, or leave a little note in his briefcase. He did the same.
But then our first son arrived and our focus completely shifted. I know that is natural, but after a few years it became apparent that we had neglected our relationship. We argued all the time. There was a lot of resentment and tension. The “D” word even came up. ‘Then one morning I woke up to find he’d made breakfast, cleaned the kitchen and got the kids ready for school, without waking me! He said he knew I’d been working hard lately and wanted to let me sleep in… In that moment, every shred of resentment I had towards him evaporated. It was amazing the way that small act of kindness made me feel completely loved. We now make an effort to do something kind every week – and it works like magic.’ Cook dinner. Take out the trash. Run a bath. Offer a foot rub. Buy your partner a present for no particular reason. In a long-term relationship, small acts can make a big difference over time. You will always have a long to-do list – perhaps it’s time to put your partner on it.
Relationship resolution no
Don’t bad-mouth your partner to others You’ve had a big fight with your partner, and you find yourself articulating a 51
Bankmed Bounce your World of Wellbeing Summer 2011/12
relationship 2 1 0 2 r resolutions fo
about acknowledging that your actions contributed to hurting someone’s feelings. It should make you, and your partner, feel better, not worse.’ It’s also worth remembering that any apology that begins with ‘I’m sorry, but…’ is no apology at all.
we may believe that conflict means the relationship is not working, when in fact conflict provides an opportunity for growth in the relationship people – if you are having difficulties in your relationship, you need to address them within your relationship,’ says clinical psychologist Adele Romanis. ‘Plus, your friends, family and colleagues may begin to hold a skewed perception of your partner, which will influence the perception they have of your partner in the future.’
Relationship resolution no
Stop stonewalling We’ve all heard the marriage folklore: An old, happily married couple respond to the question, ‘How have you managed to stay so in love after all these years?’ ‘It’s simple,’ they say, ‘we never went to bed angry.’ And while it may work for some, for others it could mean staying up till sunrise (and a lot of broken crockery). It’s not a cardinal sin to go to bed angry – in fact, it can be healthy to take a break and get some perspective before readdressing the issue – but there’s a right way and a wrong way to end an argument. Stonewalling, or shutting your partner out, is the wrong way. ‘This is what we call conflict aversion,’ says couple counsellor Lauren Clucas. ‘We might believe 52
that conflict means the relationship isn’t working – when in fact conflict provides an opportunity for growth in the relationship. If you shut your partner out, you will stifle growth.’ Not only that, evasiveness can be a form of passive aggression, where you harbour angry/aggressive emotions while behaving in a calm or detached way. This indicates that you are not comfortable expressing yourself. Consider contacting a couple counsellor if you feel you need assistance communicating with your partner.
Relationship resolution no
Master the art of apology Some people would rather be right than be in a relationship. Scary, huh? Thing is, it can be so gosh-darned difficult to apologise sometimes. It can feel like giving up. Like surrendering your self-respect. Like losing. But a real apology is none of these things. It isn’t about swallowing your pride and offering a terse, ‘Sorry’. And it definitely isn’t about who’s ‘right’. ‘It’s about putting yourself in your partner’s shoes, feeling remorse over upsetting them and then expressing this to him or her,’ says Clucas. ‘It’s
Relationship resolution no
Make nooky a priority Yes, we know, you’ve heard it all before – but it’s worth repeating. ‘Couples who maintain a sexual spark are ones who have assigned value to it,’ says Esther Perel, author of Mating in Captivity. That’s all very well for some, but with kids, jobs, and barely enough energy to brush your teeth before falling into a coma each night... Sound familiar? ‘People often become complacent in life and take their relationship for granted,’ says Romanis. ‘It is important to maintain all the hard work that you put in, and focus on the reason you have a family and a home in the first place: it’s because of the relationship you have with your partner. It is important to make time for them on a regular basis.’ What’s that, you’re never in the mood? You’d rather watch television and fall asleep on the couch? Hate to say it, but if television is higher up on your list of priorities than your partner, you might be in trouble. And if you put it off till you’re in the mood, you may be waiting a long time. Perel calls this the ‘myth of spontaneity’. But that doesn’t mean you have to ‘plan’ or ‘schedule’ sex in your diary with your other appointments and chores – that’s about as sexy as dental surgery. Rather frame it as an invitation: ‘I’m free for lunch, feel like meeting me at home for a matinée?’ or ‘Let’s book the babysitter for Thursday night.’ See it as playtime for you and your partner. After all, you know what they say: ‘The couple that plays together, stays together’.
long list of their faults to your mom, best friend or colleague. You wouldn’t be the first. It feels good to have someone in your corner, cheering you on with a sympathetic ear, right? But constantly breaking down your partner to others will contribute to the breakdown of your relationship over time. ‘A relationship involves two
it, formed life as we know The Internet has trans line along its fair share of on but it has also brought . By gisele pitot health and safety risks
here’s no denying the positive impact that the Internet has had on our everyday lives. From easy access to information and banking to conveniently communicating with friends and family in far-flung places, it’s hard for most of us to imagine how we ever got by without it. But if used incorrectly, the Internet can cause a great deal of frustration, even security concerns. Here’s how you can help ensure a healthy online experience.
Cyber spending Gone are the days of heading down to the nearest ATM – or worse, your bank branch – to check your balance or transfer money. Provided you’re linked 54
to online banking, you can do it all via the Internet. It has made shopping a breeze too. But with all this online exchange of personal information and money, how can you be sure that your passwords and cash are safe? Most shopping and banking sites have a few pages dedicated to ensuring that your information is secure. Cape Town-based software developer and IT whiz Nico Gevers says a double layer of encryption is what should be keeping you safe: ‘First, when you browse to the site you’ll see the address starts with “https”. The “s” is for secure. This means that all traffic between you and the site is encrypted. A good site should then employ two levels of
security, the first being your username and password. The second is a key generated either by a digital tag that the bank can give you, or a code smsed to your phone or emailed to your inbox. This means that if your password is weak (for example, your dog’s name), an intruder still won’t be able to access your account.’ According to the website SafeShopping.org, you can also look out for a picture of an unbroken key or closed lock in your browser window. Either one indicates that the security is operative. A broken key or open lock indicates it is not. They also suggest getting a credit card to use purely for online purchases. This makes it easier to review your statements for any irregularities, which you should immediately bring to the attention of the issuer of the credit card, and it means that you will still be able to use your other credit cards if the security of your online card is in doubt.
Facebook has come under fire at times for its lax security settings, but users have way more control than they think. It’s up to you to regularly check that your Facebook settings are limiting other users’ ability to browse your personal profile. ‘While the big social networking sites are quite trustworthy, smaller vendors are often not,’ says Gevers. ‘Allowing smaller sites, or applications (apps) to have access to your Facebook profile can lead to privacy issues. Personally, I stay away from any Facebook apps or games. It’s much better to play online games on other sites that are either free or require only some kind of username and password.’ By its very nature social networking is a voyeuristic tool, allowing you to look into other peoples’ lives, and allowing the world to follow yours. It’s a choice. Being part of the ever-changing social networking landscape can be exhilarating and fun, but remember to keep your passwords secret, and maintain a watchful eye over all thirdparty capabilities.
Cyber sprogs Every parent is nervous when it comes to mixing kids and the online world. The bottom line is that at some point the Internet will become part of your children’s lives. All the experts agree that the first step to online safety for children is open communication. Talk to them openly and honestly about the responsibilities that come with this privilege. Set behavioural expectations and boundaries while keeping that open line of communication, just as you would in any other area of the child’s life. Be practical about their Internet usage – don’t be unreasonable, allow them set time to be on the web. Put the computer in a public family space, rather than tucked away in their bedroom. Bear in mind that most user accounts and browsers have parental control applications, in which the parent can set specific limitations on site access and downloading capabilities. It is your responsibility to find out what is available to you and to use it. ‘Software that can limit the sites you can browse to is also available and can help keep your child safe. However, this software will only work on your computer and can’t protect your children from other computers,’ says Gevers. So keep those lines of communication open and build trust.
Cyber health The great part about shared resources is greater access to practical help, including sites hosted
‘Phishing’ is a phrase that brings chills to most Internet banking users. It refers to emails that appear to have been sent to you by your bank, asking you to confirm your online account’s username and password. Fraudsters then use these details to gain full access to your account. A banking institution will never ask you to supply your details via an email, or to access your online banking through a link in an email, so simply delete any emails that ask you to do so.
Gever’s top tips for safer surfing
Always use the latest available browser. Old browsers don’t support sophisticated encryption, so if you’re still running Internet Explorer 6 or 7, you put yourself at a greater risk than if you’re running version 9 or 10. Firefox and Chrome are also very good and arguably more secure browsers. Use different passwords for different sites. A program such as Keepass allows you to store the passwords for all your sites. The advantage is that you need only remember the password required for your Keepass programme. Use discernment in all your Internet dealings. It is an incredible tool for learning about anything and everything – and some common sense can go a long way to keeping you safe and secure while using it.
by legitimate health and lifestyle professionals. Sifting the good from the bad is sometimes not worth the risk, though. Many health professionals warn against leaning on the Internet for reliable health advice. The advice of a quick Google search versus that of an educated and trained professional just cannot compare. This is a question of common sense: trust the trustworthy and think twice before turning to the Internet for something more severe than a light rash or runny nose. A doctor’s experience is often worth more than the information itself. 55
Bankmed Bounce your World of Wellbeing Summer 2011/12
Cyber social networking
Absolute beginners Determined to start exercising but don’t know your sit-up from your squat? It’s easier to get into it than you may think.
by melanie farrell
new year approaches, and with it a new set of resolutions that are likely to include the shaky ‘must do some exercise’. If you’ve never done regular exercise before, you may feel nervous about taking the first step. You’re not alone. ‘For some people even the sight of a gym is disturbing, bringing back bad memories of school sport and an uncompromising and aggressive PE teacher who made them run laps around the school field in the heat of the day,’ says Trevor Meaker of Club Zero Fitness Solutions in Durban. But there’s no need to be intimidated by the world of exercise – a plan of action and an introduction to common exercise lingo will get you on the right track.
A change in attitude might be all that’s required if you need a little help getting excited about exercise. ‘Start with a different outlook and some new terminology, such as ditching the words ‘exercise’ and ‘dieting’. Your focus needs to be on “lifestyle”: living a healthy lifestyle is not about restrictions and archaic discipline, but rather about clever choices and balance,’ says Meaker. If done consistently, something as simple as walking can have huge payoffs. ‘A brisk walk for 20 minutes after work, or even during your lunch break, five days a week, is sufficient to raise your heart rate, improve blood circulation and burn off unwanted kilojoules,’ says Meaker. ‘You’ll naturally feel thirsty and want to drink more water, which, together with the improved circulation, will start cleansing your body of toxins. This means clearer, fresher looking skin, and a more effective digestive system. ‘And that’s not all. Within days of your new life you’ll start sleeping better and wake up feeling fresher, more sprightly and have greater enthusiasm at work and at home. ‘Your new, healthy lifestyle also causes your brain to release neurochemicals like dopamine, which allows us to experience pleasure, and endorphins, which act like a natural painkiller during
exercise. The result of all this is a better mood, less anxiety and the ability to focus on important tasks for longer with greater creativity and accuracy.’
Starting point Okay, so you’re convinced and raring to go. Now what? First off, avoid the urge to push yourself too hard in the beginning. Start at a pace that’s comfortable for you, increasing it as your level of fitness improves, but reducing your intensity if you experience any pain during the workout. If you’ve joined a gym, consider asking a personal trainer for some introductory sessions to show you how to work the machines correctly. And if you’re new to exercise, it’s wise to consult a doctor for a full medical check-up before you start. Once you have been given the all clear, you are good to go. Helen Fizzotti, personal trainer at Virgin Active in Green Point, Cape Town, says a beginner’s programme could look something like this: ■ First four weeks: Kick-start your exercise programme by cycling or walking three times a week for 20 to 25 minutes. As your level of fitness improves you can start increasing the intensity of the exercise by increasing the pace, exercising on different terrain and introducing some hills. But again,
Bearing the many benefits of exercise in mind will keep you going when you feel like throwing in the towel. Fizzotti says, ‘It’s important to exercise because it stimulates your metabolism, strengthens muscles and bones (helping prevent the onset of osteoporosis) and prevents hypertension and high cholesterol.’ And if that’s not enough, consider the significant role exercise plays in slowing the ageing process. Meaker says that the physical aspect of fitness is not just about a healthy heart and losing weight. ‘When you reach your late 30s, your body starts breaking down muscle and losing flexibility. Once you feel ready to add some resistance training to your walking/cycling routine, you will improve muscle tone, which not only looks great but supports your joints and keeps you looking young.’
you should never overdo it – at the end of your workout you should still be able to hold a conversation without being too out of breath.
Bankmed Bounce your World of Wellbeing Summer 2011/12
A new outlook
what’s in it for you?
Know the exercise lingo so you don’t get caught looking confused when exercise enthusiasts throw about fitness terms: ■ Abs – Abdominal muscles. ■ Aerobic exercise – Also called aerobics, this is a system of sustained exercises designed to increase the amount of oxygen in the blood and strengthen the heart and lungs. It includes any activity that uses large muscle groups, can be maintained continuously and is rhythmic in nature. Examples: running, cross-country skiing and cycling. ■ Cardiovascular training – Also called ‘cardio’, this refers to physical conditioning that strengthens heart and blood vessels, improving fitness levels and increasing the ability of the muscles to use fuel effectively. Examples: running, stair climbing, skipping. ■ Circuit training – This involves moving quickly from one exercise apparatus to another and doing a prescribed number of exercises on each apparatus. This keeps the pulse rate high and promotes overall fitness by generally working all muscle groups as well as the heart and lungs. ■ Crunches – Sit-ups done on the floor. ■ Lats – Short for latissimus dorsi, the large muscles of
the back that move the arms downward, backward and in internal rotation. ■ Lower abs – The abdominal muscles below the navel. ■ Muscle tone – When a muscle is in a light but constant state of contraction and appears firm. ■ Obliques – The external oblique muscles on either side of abdominals that rotate and flex the trunk. ■ Pecs – The pectoral muscles of the chest. ■ Quads – Short for the quadriceps femoris muscles on the upper front part of the thighs. ■ Repetition – Reps for short. Refers to one complete movement of an exercise. ■ Resistance training – Exercise involving weights or using body weight. Examples: water aerobics, using free weights, squats and push-ups. ■ Set – This refers to a fixed number of repetitions. For example, 10 repetitions may comprise one set. ■ Traps – Short for trapezius muscles, the largest muscle of the back and neck that draws the head backwards and rotates the scapula.
■ Before and after: It’s always important to do warm-up exercises before the main activity to prevent injury. These usually take the form of a slower version of the activity to follow that helps prepare the body for physical activity, for example a light jog before a run, followed by basic stretching exercises. Cooling down after exercising is just as important. This consists of moderate, then light activity, and helps the heart rate slowly return to a resting point. You can do a lighter version of the exercise just performed, or any low-intensity exercise. Again, this should be followed by a series of stretches, which help the muscles return to their normal form.
Discovery Vitality offers a variety of fantastic fitness benefits to suit every age, from reduced rates on gym memberships to Vitality points for certain activities. For more information on Vitality’s fitness benefits or to join Vitality, call 0860-110833. To enrol in a Bankmed Special Care Programme, call 0800-BANKMED (0800-2265633), or send an email to firstname.lastname@example.org.
talk the talk
■ After the initial four weeks: Start adding floor exercises to your fitness routine to improve muscle tone, including abdominal crunches, leg lifts and light weight training. Alternatively, these exercises could be done on weight training machines at the gym. To benefit from these exercises you need to do 10 to 12 repetitions and two or three sets at least twice a week. (See ‘Talk the Talk’ on the left for an explanation of the concepts of sets and repetitions.)
Without SoundRecover ® my orchestra sounds like heavy metal Dieter Wolfgang Conductor
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foodbytes From the best food blogs to reinventing the ice lolly, here is what’s new and interesting in the world of food. By candice verwey
Best food blogs
Fancy yourself something of a foodie? Then the South African Blog Awards list of top food blogs for 2011 is sure to tickle your taste buds. They are pure, delicious genius! ■ aficionado.co.za/jamiewho ■ blog.kumkani.com ■ blog.arniston-bay.com ■ cooksister.com ■ blogs.food24.com/janicetripepi ■ maclarty.blogspot.com ■ my-easy-cooking.com ■ simply-delicious.co.za ■ thefoodie.co.za
Get your braai on with Braai Buddy 2 (RHS)
the skinny smoothie Most of us are a little more diet conscious during the summer months. This creamy berry smoothie is the ideal treat to satisfy your appetite and curb any cravings for unhealthy goodies. Ingredients: • 1 banana • 1/2 cup fresh or frozen berries – strawberries, raspberries and blackberries work well • 1/2 cup low-fat milk
• 1/2 cup fat-free plain or
vanilla yoghurt • Honey to taste METHOD: Blend until smooth and enjoy!
Tired of braaiing the same old chops and wors? You need De Waal Davis’s inspired collection of recipes devoted to South Africa’s favourite national pastime, the braai. In keeping with current trends in taste and cooking, Davis has included sections on gas cooking, the pros and cons of wood versus gas, and classic ‘steakhouse’ sauces. The potjie section has a range of delicious recipes from around the world. Chapters also cover bastes, dry rubs, glazes, marinades, steaks, beef, chicken, lamb, pork and fish. There is even a ‘controversial’ guest list! Colin Daniel’s cartoonstyle illustrations add a
further dimension to this recipe compilation for the serious braaier with a serious sense of humour.
We are giving away five copies of Braai Buddy 2. To be in line to win one copy, sms the words Bounce/Braai, with your full name, postal address and daytime phone number, to 34509 by 31 January 2012.
Ceres fruit juice has a new flavour that will quench even the meanest thirst this summer. Full Moon Harvest offers a heady mix of flavours, from berries and pears to a delectable burst of peach. As with all Ceres fruit juices, it’s free of added sugar and preservatives. Full Moon Harvest is naturally low in fat, high in nutrition and rich in vitamin C. Enjoy it over lots of ice for a refreshing drink the whole family will enjoy.
Don't be a drip!
Kids love ice cream, but it’s a pain when the ice cream melts and starts dripping through the bottom of the cone. When next you bring out the cones, pop a mini marshmallow into the bottom of the cone before adding the ice cream, and the mess will be a thing of the past!
Reinventing the ice lolly
Impress your friends and knock the socks off your kids with the new Zoku® QuickPop™ maker. Using quick-freeze technology it makes healthy ice lollies in seven minutes – you can actually watch the lollies freeze before your eyes! It works with almost any type of juice, fresh fruit pulp, fat-free yoghurt, sweetened coffee, chocolate milk, or fruit smoothies, and you can get creative with striped pops, creamy-centred pops, fruit-adorned pops and more. Zoku is available at selected Boardmans stores nationwide and online from yuppiechef.co.za. Price: R499.
We are giving away one Zoku ice-lolly maker. To be in line to win, SMS the words Bounce/Zoku, with your full name, postal address and daytime phone number, to 34509 by 31 January 2012.
Beat the heat with rooibos tea
This summer consider rooibos tea the main ingredient in your poolside drinks. Laager rooibos tea is caffeine free and has a fragrant, naturally sweet flavour that makes it the perfect fit for refreshing iced teas, shakes or sorbets. Among its many benefits, rooibos has a calming effect on the central nervous system, soothes the digestive system and promotes healthy, glowing skin. Look out for Laager rooibos tea at leading retailers countrywide. The range includes Laager Green Rooibos, Green Rooibos Citrus and Ginger, and Rooibos and Honeybush.
giveaway We are giving away three hampers, worth R1 000 each, of one Neoflam 24cm casserole dish, a
tea hamper and a rooibos cookbook. To be in line to win one hamper, sms the words Bounce/Laager, with your full name, postal address and daytime phone number, to 34509 by 31 January 2012.
Bankmed Bounce your World of Wellbeing Summer 2011/12
IMAGEs: shutterstock, SUPPLIED, addtotaste.blogspot.com, www.sciencedaily.com, www.health24.com
new on shelves
feeding picky eaters! be tough Dinner-time histrionics getting you down? Coping with picky eaters can – but there are sneaky ways to get around it. By robyn maclarty
eaters. ‘Supermarkets and brands know just how to appeal to kids by packaging sweetened junk food in wrappers with pictures of their favourite characters,’ says Perkel. This might be the case, but it doesn’t help you when it comes to ensuring that the picky eaters in your house (children and adults alike) are getting enough of the good stuff in their diet. Here’s what the experts suggest:
Lead by example
introducing a new vegetable daily will increase veggie acceptance.’
Make mealtimes story time Perkel suggests reading to your children while they eat if they find it difficult to sit still long enough to finish their meals. The idea is to create a positive environment around food and eating – make it fun rather than a battleground.
‘Choose healthy foods for yourself and chances are that your child will be more than willing to eat vegetables and fruit later on,’ says paediatric dietitian Lee-Anne McHarry. ‘As they grow, don’t devour chocolates in front of them and then tell them it’s bad for them. Instead, show enthusiasm for healthy food.’
Allow your children to make choices
‘Let children help with the food preparation,’ says McHarry. ‘Let them wash food, tear the lettuce, sprinkle grated cheese – whatever you are making, find something easy and safe for the children to do. And of course it’s a case of the messier, the better.’
‘Teach your children to eat a variety of food by exposing them to lots of healthy food options from as young a possible,’ says clinical paediatric dietitian and co-founder of Nutripaeds (Nutripaeds.co.za), Kath Megaw. ‘The most critical phase is the age between six to nine months old, during solid food introduction. This is when you must offer as much variety as possible. Studies have shown that
‘Be careful about the amount of control you exercise over your children’s eating habits,’ says Perkel. ‘Children need to have some freedom to make their own choices and to live their own lives, even when they are very young.’
If your kids love fast food – and which child doesn’t – get creative and make homemade alternatives to their favourite takeways. They’re healthier,
very parent has their tipping point. Perhaps you spent the last 20 minutes arranging a Da Vinci-esque rendering of Harry Potter out of organic peas and carrots, only to see the whole thing merrily tipped onto the floor. It doesn’t matter that you’ve had this scene described to you a hundred times in parenting magazines or by other moms, it’s a unique sort of heartbreak when it’s your child who is rejecting your lovingly prepared food. But don’t take it personally – researchers from University College London examined the eating habits of 5 390 pairs of twins between eight and 11 years old and found children’s aversions to trying new foods are mostly inherited. So, according to science, it’s probably not your cooking but your genes. Jenny Perkel, clinical psychologist and author of Babies in Mind (Jennyperkel.com), suggests that sneaky marketing tactics may also play a part in encouraging picky
contain less fat and provide more fibre and nutrients than their takeaway counterparts. Try these: ■ Homemade lean beef or chicken burger with a wholewheat bun and fresh salad. ■ Mini pizzas, easy on the cheese but loaded with good stuff, such as lean chicken, pineapple, peppers, mushrooms, asparagus and courgettes. ■ Baked sweet potato chips, with the skin left on. ■ Baked chicken strips coated in crunchy wholegrain breadcrumbs as an alternative to fatty chicken nuggets.
Recipes ‘Disappearing’ roasted vegetable pasta Serves 6 Ingredients: 1 medium zucchini, diced 1 red or yellow pepper, seeded and diced 1 large red onion, thinly sliced 2 tbsp extra-virgin olive oil, divided Sea salt and freshly ground pepper, to taste 2 large tomatoes, chopped
1/4 cup chopped fresh basil 2 cloves garlic, minced 350g wholewheat pasta 1/2 cup crumbled feta cheese
Method: 1. Preheat oven to 200°C. Bring a large pot of lightly salted water to the boil. 2. Toss zucchini, pepper and onion with 1 tbsp oil in a large roasting pan. Season with salt and pepper. Roast the vegetables, stirring after 10 minutes, 63
Bankmed Bounce your World of Wellbeing Summer 2011/12
until tender and browned – about 20 minutes. 3. Transfer vegetables to a food processor and blend until smooth. Add the tomatoes, basil, garlic and the remaining 1 tbsp oil and blend until smooth. Season with salt and pepper. 4. Cook pasta until just tender – 8 to 10 minutes. Drain and transfer to a bowl. Add the roasted vegetable sauce and toss well. Serve topped with crumbled feta cheese, or cheese of their choice. Nutritional analysis per serving: ■ 1210 kilojoules ■ 12g fat ■ 17mg cholesterol ■ 75g carbohydrates ■ 6g fibre ■ 17g protein
TIP: Add 2 cups sautéed lean beef mince for a more substantial sauce. You could also try other vegetables such as butternut, pumpkin, peas, carrots or baby corn.
Veggie quesadillas Makes 6 Ingredients: 200g fresh mushrooms, grated 1 medium zucchini, grated 1/2 cup spring onions, finely chopped 2 x 410g cans whole kernel corn, drained 2 tomatoes, seeded and finely diced 1 tsp finely chopped basil Sea salt and freshly ground pepper, to taste 6 flour tortillas 2 cups reduced-fat cheddar cheese
Method: 1. In a large frying pan coated with nonstick cooking spray, sauté the mushroom, zucchini and onion until tender. 2. Add the corn, tomato, basil, salt and pepper. Cook 2 to 3 minutes longer, or until heated through. 3. Using a slotted spoon, spoon filling onto half of each tortilla. Sprinkle vegetable mixture with cheese and fold tortilla over. 4. Lightly spray top of tortillas with nonstick cooking spray. Bake, uncovered, at 200°C for 10 to 12 minutes, or until golden. 5. Slice into quarters and serve with salsa and a little sour cream. TIP: Add bacon bits for some extra flavour. Nutritional analysis per serving ■ 1571 kilojoules ■ 12g fat ■ 18mg cholesterol ■ 53g carbohydrate ■ 7g fibre ■ 23g protein
Serves 4 Ingredients: 1/2 cup wholewheat flour 1/4 cup all-purpose flour 1 tsp sugar 1 tsp baking powder 1/4 tsp sodium bicarbonate 1/2 tsp freshly grated nutmeg 3/4 cup ricotta cheese 1 large egg 1 large egg white 1/2 cup buttermilk (low fat, if possible) 1 tsp freshly grated lemon zest 1 tbsp lemon juice 2 tsp canola oil, divided 3/4 cup fresh or frozen (but not thawed) blueberries
Mom knows best! Tips and tricks from those in the know. ■ ‘I provide fruit or vegetables before the main meal. That’s when they’re hungry and they happily eat those while waiting for the “real thing”, usually yummy carbs, to arrive.’ – Karin, 42, mother of Oliver, 13, and Julia, 11
Method: 1. Whisk the wholewheat flour, all-purpose flour, sugar, baking powder, baking soda and nutmeg together in a small bowl. 2. Whisk ricotta, egg, egg white, buttermilk, lemon zest and juice in a large bowl until smooth. Stir the dry ingredients into the wet ingredients until just combined. 3. Brush a large nonstick frying pan with 1/2 tsp oil and place over medium heat until hot. Using a generous 1/4 cup of batter per pancake, pour the batter for 2 pancakes into the pan, sprinkle blueberries on each pancake and cook until the edges are dry and bubbles begin to form – about 2 minutes. 4. Flip the pancakes and cook until
golden brown, about 2 minutes more. Repeat with the remaining oil, batter and berries, adjusting the heat as necessary to prevent burning. Serve with honey. Nutritional analysis per serving: 1000 kilojoules 8g fat 68mg cholesterol 30g carbohydrates 3g fibre 12g protein
TIP: Use metal cookie cutters to make the pancakes into appealing shapes. Feel free to substitute the blueberries with other berries of your choice.
■ ‘I purée vegetables to the point where they are unidentifiable, which usually works. Also, don’t give up. I keep serving a food if it’s really healthy for them. Even if they don’t like it, they just need to try it a few times before they develop a taste for it.’ – Shelley, 30, mother of Tyler, 9, Megan, 6, Brian, 4, and Josh, 1 ■ ‘I serve my daughter’s food creatively. I will put grilled chicken in one bowl, two types of veggies in smaller bowls and various salad in another bowl, so she gets a buffet of nice things to snack on.’ – Michelle, 36, mother of Kaitlin, 5
Bankmed Bounce your World of Wellbeing Summer 2011/12
■ ‘I try to make a salad with most meals. At least then they eat some lettuce, tomato and cucumber. My youngest picks out the pepper strips but my older child eats them.’ – Janet, 45, mother of Johan, 10 and Justin, 7
SuperHeavy (Universal Music) Mick Jagger teamed up with the founder of The Eurythmics, Dave Stewart, soul singer Joss Stone, Academy Award-winning composer and global superstar A. R. Rahman and reggae star Damian Marley to form a band cooperative project called SuperHeavy. This diverse and eclectic lineup, who boast 11 Grammy Awards between them, have been recording together in studios around the world. The majority of the tracks were laid down in LA in 2011. If you're looking for something different, this one is for you. 'It’s really unexpected; it’s mind-blowing,' enthuses Stone. We are giving away three copies of SuperHeavy. To be in line to win one of the copies, SMS the words Bounce/SuperHeavy, your full name, contact number and postal address, to 34509 before 31 January 2012.
Florence and the Machine (Universal Music) This album follows on from the British band's hugely successful debut album, Lungs, and explores the ever-popular themes of love and romance, but with a macabre twist. Lead singer Florence Welch's deep lyrics are accompanied by a harp, guitar, drums and piano, conveying drama, angst, love and passion in an album that sees the band staying true to itself and daring to be unusual. Rolling Stone's Jody Rosen called Ceremonials 'dark, robust and romantic', while The Washington Post referred to it as 'an unabashedly big record'. We are giving away three copies of Ceremonials. To be in line to win one of the copies, SMS the words Bounce/Ceremonials, your full name, contact number and postal address, to 34509 before 31 January 2012.
James Morrison (Universal Music) This is a warm collection of classic but contemporary folk-soul songs that has the feeling of a live recording. As the title suggests, it is the sound of an artist coming of age. There are musical similarities with Morrison’s debut, but this time with added self-belief. Technically, Morrison remains one of the finest white soul singers – equal parts Stevie Wonder and Paul Young. But he is more than just a 'big voice' – he sings from the heart. We are giving away three copies of The Awakening. To be in line to win one of the copies, SMS the words Bounce/Awakening, your full name, contact number and postal address, to 34509 before 31 January 2012.
books The Cat's Table
Michael Ondaatje (Penguin) This is the latest offering from the acclaimed author of The English Patient and In the Skin of a Lion. In the early 1950s, an 11-year-old boy boards a huge ocean liner bound for England. At mealtimes, he is placed at the lowly ‘Cat’s Table’ with an eccentric group of grown-ups and two other boys, Cassius and Ramadhin. As the narrative moves from the decks and holds of the ship to the boy’s adult years, it tells the spellbinding story of the difference between the magical openness of childhood and the burdens of earned understanding; about a life-long journey that began unexpectedly with a spectacular sea voyage, when all on board were ‘free of the realities of the earth’. We are giving away three copies of The Cat's Table. To be in line to win, SMS the words Bounce/Cat's Table, with your full name, postal address and daytime phone number, to 34509 by 31 January 2012.
Against All Enemies
Tim Noakes & Michael Vlismas (Random House Struik) Tim Noakes is one of the world’s leading authorities on the science of sport. Through a lifetime of research, he has developed key scientific concepts in sport that have not only redefined the way elite athletes and teams approach their professions but challenged conventional thinking in these areas. In Challenging Beliefs Noakes gives his views on everything from the myths perpetuated by the sports-drink industry and the dangers of overtraining and overdrinking to the prevalence of banned substances and the need to make rugby a safer sport. We are giving away five copies of Challenging Beliefs. To be in line to win, SMS the words Bounce/Beliefs, with your full name, postal address and daytime phone number, to 34509 by 31 January 2012.
Bankmed Bounce your World of Wellbeing Summer 2011/12
Tom Clancy (Random House Struik) Clancy, the master of international intrigue and explosive action, introduces a new hero for a new era of warfare – against a new kind of threat. For years, ex-Navy Seal Maxwell Moore has worked all over the Middle East and behind the scenes for the Special Activities Division of the CIA, making connections, extracting valuable intelligence and facing off against America's enemies at every turn. When Moore arrives at a rendezvous to take charge of a high-ranking Taliban captive, the meeting takes a horrific turn that neither Moore nor any of his bosses saw coming. We are giving away five copies of Against All Enemies. To be in line to win, SMS the words Bounce/Enemies, with your full name, postal address and daytime phone number to 34509 by 31 January 2012.
puzzles CRYPTIC CLUES 2
1. So exultant to cook a chop like this? (4-1-4) 8. Fit for a little physical exercise (3) 9. women who have no-one to mow their lawns? (5,6) 11. Touch on what brought Zulu warriors to a strange end (7) 12. There’s space to travel in it (5) 13. Rush in with a demand for money? (6) 15. Indiscreet bank official? (6) 17. Doubtful, being somewhat in the dark? (5) 18. It grows, in the main (7) 20. When it’s too humid to hunt? (5,6) 22. Born in a stone edifice (3) 23. Carries away the gates (9)
Quick Crossword answers also fit the large grid
ACROSS 1. 8. 9. 11. 12. 13. 15. 17. 18. 20. 22. 23.
Exercising choice (9) Choose (3) Respectful (11) Disagree (7) Precise (5) A delicacy (6) Muscular (6) Light boat (5) Win back (7) Warlike (11) Fish (3) Show (9)
2. 3. 4. 5. 6.
7. 10. 11. 14. 16. 19. 21.
Sheep (3) Oath (5) Inborn (6) Obvious (7) Work in co-operation (11) Artifice (9) Chic (11) Devoted (9) Latticework (7) Extol (6) Defraud (5) Nothing (3)
2. It moves boats in Morocco, Arabia and Israel (3) 3. A crime for which a clergyman lost his head (5) 4. Nothing exists but fruit (6) 5. Irritate but prove all right before the end (7) 6. They were once thought, though almost entirely incredible (4,7) 7. Spoke in broken English? (9) 10. They’re put in by present company (11) 11. Endless instances developed (9) 14. It’s used by those wishing to secure temporary accommodation (3-4) 16. Maintain a lock that is brought up (6) 19. Engagement ring from one who will care, naturally! (5) 21. Person in the money? (3)
Check your answers on opposite page
QUICK CLUES 1
Quick crossword answers Across 1 Selective 8 Opt 9 Deferential 11 Dissent 12 Exact 13 Dainty 15 Strong 17 Canoe 18 Reclaim 20 Belligerent 22 Eel 23 Spectacle. DOWN 2 Ewe 3 Curse 4 Innate 5 Evident 6 Collaborate 7 Stratagem 10 Fashionable 11 Dedicated 14 Trellis 16 Praise 19 Cheat 21 Nil
Across: 1 Cock-a-hoop 8 Apt 9 Grass widows 11 Impinge 12 Orbit 13 Charge 15 Teller 17 Shady 18 Seaweed 20 Close season 22 Nee 23 Entrances. Down: Down: 2 Oar 3 Arson 4 Olives 5 Provoke 6 Past beliefs 7 Stuttered 10 Appearances 11 Incessant 14 Guy-rope 16 Assert 19 Arena 21 One.
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Bankmed Bounce your World of Wellbeing Summer 2011/12
69 Cryptic crossword answers
solutions difficulty rating: SOLUTIONS TO PUZZLE 10,041
sudoku double crossword
SPOT THE DIFFERENCE 1. Brick missing from wall 2. Drop of wine missing 3. Grape missing 4. Crack not in jug 5. Sandals missing straps 6. Necklace changed colours 7. Claws missing from chair legs 8. Wreath missing a leaf 9. Extra hair next to ear 10. Base of soldiers spear WORD FIND Solution: â€œFood Shoppingâ€? JOIN THE DOTS
Join the dots from 1 to 26 to find out what came from another planet
Join the dots
Have some puzzle fun and tickle your mind with these brain-teasers
At the grocery store
Solution: 11 letters The words below can all be found in the puzzle. They may be spelled horizontally, vertically, backwards, forwards or diagonally. Be careful, some letters are used more than once. When you find a word, circle each letter. When all the words in the list have been found, the letters left over will spell the solution. Aisle Basket Boxes Carton
Checkout Customer Dairy Display
Fresh Frozen List Price
Can you find all 10 differences in this cartoon?
Retail Sale Scale Vegetables
F N O T R A C O O S D S R E T A I L E T Y C S S A L E L N U A D U E I H B E B O
IMAGES: inpra, shutterstock
L A O S X A Z A A K P I T P T O P I S C S R P E R O B S K E I Y G F I I M L E H D E L A C S C E T C V N F R E S H E R G
Check your Spot the Difference and Word Find answers on the opposite page
Bankmed Bounce your World of Wellbeing Summer 2011/12
Bankmed cut-outand-keep numbers Important Bankmed contacts for when you need to get in touch Customer Services π Telephone (toll free) 0800-Bankmed (0800-226-5633) π Email email@example.com Pre-authorisation for hospitalisation, MRI/CT scans and radionucleotide scans π Telephone (toll free) 0800-Bankmed (0800-226-5633) π Fax 021-480-2744 π Email firstname.lastname@example.org
Baby-AND-ME π 24-hour advisory hotline 0800-Bankbaby (0800-226-5229) π Fax 021-480-2744 π Email email@example.com Oncology Treatment Programme π Telephone (toll free) 0800-Bankmed (0800-226-5633) π Fax 021-480-2744 π Email firstname.lastname@example.org
Medicine Advisory Programme (authorisation for chronic medicineS) π Telephone (toll free) 0800-Bankmed (0800-226-5633) π Fax 021-480-2736 π Email email@example.com Special Care Programmes (Asthma, Diabetes, CVD and Depression) π Telephone (toll free) 0800-Bankmed (0800-226-5633) π Fax 021-480-2736 π Email firstname.lastname@example.org pensioner service π Telephone (toll free) 0800-Bankmed (0800-226-5633), then press ‘2’ π Email email@example.com HIV/AIDS Confidential Line π Call 0861-888-300 Discovery Vitality π Call 0860-110-833 Fraud Line π Call 0800-200-564 BaNKMED MAGAZINE π Email firstname.lastname@example.org
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